Population Attributable Fractions of Modifiable Risk Factors for Nonsyndromic Orofacial Clefts: A Prospective Cohort Study From the Japan Environment and Children’s Study
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- Sato Yukihiro
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
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- Yoshioka Eiji
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
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- Saijo Yasuaki
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
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- Miyamoto Toshinobu
- Department of Obstetrics and Gynecology, Asahikawa Medical University
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- Sengoku Kazuo
- Department of Obstetrics and Gynecology, Asahikawa Medical University
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- Azuma Hiroshi
- Department of Pediatrics, Asahikawa Medical University
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- Tanahashi Yusuke
- Department of Pediatrics, Asahikawa Medical University
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- Ito Yoshiya
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing
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- Kobayashi Sumitaka
- Center for Environmental and Health Sciences, Hokkaido University
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- Minatoya Machiko
- Faculty of Health Sciences, Hokkaido University
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- Bamai Yu Ait
- Center for Environmental and Health Sciences, Hokkaido University
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- Yamazaki Keiko
- Center for Environmental and Health Sciences, Hokkaido University
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- Itoh Sachiko
- Center for Environmental and Health Sciences, Hokkaido University
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- Miyashita Chihiro
- Center for Environmental and Health Sciences, Hokkaido University
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- Araki Atsuko
- Center for Environmental and Health Sciences, Hokkaido University
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- Kishi Reiko
- Center for Environmental and Health Sciences, Hokkaido University
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Abstract
<p>Background: Population impact of modifiable risk factors on orofacial clefts is still unknown. This study aimed to estimate population attributable fractions (PAFs) of modifiable risk factors for nonsyndromic cleft lip with or without cleft palate (CL±P) and cleft palate only (CP) in Japan.</p><p>Methods: We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women from 2011 to 2014. We estimated the PAFs of maternal alcohol consumption, psychological distress, maternal active and passive smoking, abnormal body mass index (BMI) (<18.5 and ≥25 kg/m2), and non-use of a folic acid supplement during pregnancy for nonsyndromic CL±P and CP in babies.</p><p>Results: A total of 94,174 pairs of pregnant women and their single babies were included. Among them, there were 146 nonsyndromic CL±P cases and 41 nonsyndromic CP cases. The combined adjusted PAF for CL±P of the modifiable risk factors excluding maternal alcohol consumption was 34.3%. Only maternal alcohol consumption was not associated with CL±P risk. The adjusted PAFs for CL±P of psychological distress, maternal active and passive smoking, abnormal BMI, and non-use of a folic acid supplement were 1.4% (95% confidence interval [CI], −10.7 to 15.1%), 9.9% (95% CI, −7.0 to 26.9%), 10.8% (95% CI, −9.9 to 30.3%), 2.4% (95% CI, −7.5 to 14.0%), and 15.1% (95% CI, −17.8 to 41.0%), respectively. We could not obtain PAFs for CP due to the small sample size.</p><p>Conclusions: We reported the population impact of the modifiable risk factors on CL±P, but not CP. This study might be useful in planning the primary prevention of CL±P.</p>
Journal
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- Journal of Epidemiology
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Journal of Epidemiology 31 (4), 272-279, 2021-04-05
Japan Epidemiological Association