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Lipid metabolism and maternal weight influence orofacial cleft risk in infants

New data indicates that both maternal weight and lipid metabolism have a dramatic impact on the likelihood of an infant developing an orofacial cleft. (Image: PeopleImages.com – Yuri A/Shutterstock)

KHON KAEN, Thailand: Orofacial clefts (OFCs) occur at a slightly higher rate in Asia than elsewhere—1.6 cases per 1,000 live births compared with one in 700–1,000 globally—and place a major burden on families regarding healthcare and psychosocial affects. A study conducted in Thailand has investigated whether metabolic syndrome is a factor in such congenital defects and determined that mothers outside of normal weight ranges are more likely to have a baby with an OFC. Those with low levels of high-density lipoprotein cholesterol (HDL-C) also have increased OFC risk, highlighting the importance of lipid metabolism in OFCs.

In north-east Thailand, between June 2017 and May 2021, the researchers studied 94 infants with cleft lip with or without cleft palate and 94 controls frequency-matched on age and mother’s education level. Data collection included maternal health questionnaires, anthropometric measurements and blood samples measuring HDL-C. Metabolic syndrome was defined using the International Diabetes Federation criteria, requiring central obesity plus two additional risk factors.

Mothers with a body mass index that was considered overweight were at a 2.44 times higher risk of having infants with OFCs compared with mothers of normal weight, and obese mothers were at 3.30 times higher risk. Mothers with low maternal HDL-C levels were also 2.95 times more likely to have children who developed OFCs. Although not a statistically significant finding, mothers exhibiting four or five features of metabolic syndrome showed an increased likelihood of having children with OFCs. Surprisingly, mothers who were underweight were 2.93 times more likely to have a child with an OFC.

The results remained consistent when excluding infants with a family history of OFCs and among mothers not currently breastfeeding or those more than six months postpartum. The study findings corroborate those reported in other countries and suggest the importance of promoting strategies to maintain optimal body weight and enhance HDL-C levels among reproductive-age and pregnant women to potentially reduce the risk of OFCs in their children.

The study, titled “Maternal metabolic status and orofacial cleft risk: A case-control study in Thailand”, was published online on 12 April 2024 in the International Dental Journal, ahead of inclusion in an issue.

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