Abstract
To assess the association between maternal active cigarette smoking and the risk of oral clefts in the offspring. Oral clefts are divided into three subgroups: total clefts, cleft lip with or without cleft palate (CL±P), and cleft palate only (CP). Data from studies on different levels of smoking were gathered to examine the dose-response effect. The present meta-analysis included 29 case-control and cohort studies through Cochrane, PubMed, and Ovid Medline searches. A modest but statistically significant association was found between maternal active smoking and CL±P (odds ratio [OR] 1.368; 95% confidence interval [CI] 1.259-1.486) as well as CP (OR 1.241; 95% CI 1.117-1.378). Half the studies showed positive dose-response effect for each subgroup (test for linear trend, P<.05). There is a moderate risk for having a child with a CL±P or CP in women who smoke during pregnancy. We could not confirm whether there was a positive dose-response effect between maternal smoking and clefts.
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