Impact of maternal body mass index and gestational comorbidities on the birth prevalence of orofacial clefts in the Japan Environment and Children's Study.

Shinobu TSUCHIYA; Masahiro TSUCHIYA; Haruki MOMMA; Masatoshi SAITO; Chiharu OTA; Kaoru IGARASHI

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Impact of maternal body mass index and gestational comorbidities on the birth prevalence of orofacial clefts in the Japan Environment and Children's Study.

Author: Shinobu TSUCHIYA ¹ ; Masahiro TSUCHIYA ² ; Haruki MOMMA ³ ; Masatoshi SAITO ⁴ ; Chiharu OTA ⁵ ; Kaoru IGARASHI ¹
Author Information

1. Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital.
2. Department of Nursing, Tohoku Fukushi University.
3. Laboratory of Well-Being, Center for Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition.
4. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine.
5. Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine.
Publication Type:Journal Article
Keywords: Birth cohort; Body mass index; Cleft lip and palate; Gestational diabetes; Gestational hypertension
MeSH: Humans; Female; Cleft Lip/etiology*; Cleft Palate/etiology*; Pregnancy; Japan/epidemiology*; Prevalence; Body Mass Index; Adult; Male; Infant, Newborn; Comorbidity; Diabetes, Gestational/epidemiology*; Risk Factors; Young Adult; Birth Cohort
From:Environmental Health and Preventive Medicine 2025;30():86-86
CountryJapan
Language:English
Abstract: BACKGROUND:An increased prevalence of cleft lip and/or palate (CL/P), a major congenital anomaly, has been observed in the offspring of women with elevated body mass index (BMI) before pregnancy. Likewise, gestational comorbidities, such as hypertension and diabetes mellitus, also increase the risk of CL/P; however, the risk linked to the coexistence of these conditions in women with higher BMI on birth prevalence of CL/P remains unclear. This study focused on the combined effects of a high BMI before pregnancy and gestational comorbidities on the birth prevalence of CL/P.
METHODS:Among 98,373 live births from the Japan Environment and Children's Study (JECS), a nationwide birth cohort, 255 mothers of infants with CL/P (74, 112, and 69 infants born with cleft lip, cleft lip and palate, and isolated cleft palate, respectively) were included in the analyses. The association of CL/P birth prevalence with pre-pregnancy BMI and gestational comorbidities (hypertension and diabetes) was examined using multivariate logistic regression analyses after multiple imputations, with adjustments for several maternal (age at delivery, smoking habits, and alcohol intake) and child-related (sex and prevalence of other congenital diseases) variables, obtained through medical record transcriptions and self-reports on JECS transcription forms.
RESULTS:Higher prevalence rates of overweight, gestational hypertension, and gestational diabetes mellitus were found in mothers of infants with CL/P (16.1%, 6.3%, and 4.7%, respectively) than in the control group (10.4%, 3.1%, and 3.1%, respectively). The odds ratio [95% confidence interval] for childbirth with CL/P was increased in mothers with high BMI before pregnancy (1.58 [1.11-2.24]). Furthermore, gestational hypertension and diabetes coexisting with high BMI additionally increased the odds ratios for childbirth with CL/P (2.91 [1.28-6.61] and 2.12 [0.87-5.19], respectively).
CONCLUSION:High maternal BMI, particularly when accompanied by gestational hypertension, was significantly associated with an increased prevalence of childbirth with CL/P.