CC BY 4.0 · European Journal of General Dentistry 2025; 14(01): 080-087
DOI: 10.1055/s-0044-1788561
Original Article

Analysis of Influencing Risk Factors of Nonsyndromic Unilateral Cleft Lip in South Sulawesi

1   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
M. Hidayat Sakti Rusdin
1   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
Nurwahida Nurwahida
1   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
Abul Fauzi
1   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
Muhammad Irfan Rasul
1   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
R. Aries Muharram
2   Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Airlangga University, Surabaya, Indonesia
› Author Affiliations

Abstract

Objective This study is to determine the most dominant risk factors for the potential occurrence of nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia.

Materials and Methods This is a retrospective study of several hospitals in South Sulawesi, Indonesia. An analysis was performed on the medical records of patients with nonsyndromic unilateral clefts. In the period from January 2018 to December 2022, risk factors include gender, parental education, family history of cleft lip and palate, maternal history of smoking or exposure to secondhand smoke, and consumption of drugs and alcohol during gestational age. The size of the sample is determined using the cluster sampling technique. Statistics uses chi-square test analysis and logistic regression for nominal variables. It uses SPSS Statistics version 25, with a value of p < 0.05.

Results The highest risk factor was found in patients with parents with a history of alcohol consumption during pregnancy and in patients with family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender. In comparison, parents' education level does not have a significant influence.

Conclusion History of alcohol consumption during pregnancy, family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender are considered risk factors for nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia.

Consent for Participant

Inform consent was obtained from all individual participants included in the study.


Ethical Approval

Prior to starting the research, a research proposal was submitted to the Ethics Commission of the Faculty of Dentistry (FKG), Hasanuddin University (UNHAS) and the Teaching Oral and Dental Hospital (RSGMP), Hasanuddin University (UNHAS) to obtain ethical approval recommendation no. 0011/PL.09/KEPK FKG-RSGM UNHAS/2023 dated January 24, 2023. It is intended that this research can be ethically accounted for and legitimized.


Inform Consent

All participants gave written informed consent before the study began.




Publication History

Article published online:
16 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Wehby GL, Cassell CH, Tanaka SA. et al. Cleft lip and palate. An evidence-based review. Plast Reconstr Surg 2013; 16 (03) 1-16
  • 2 Mbuyi-Musanzayi S, Kayembe TJ, Kashal MK. et al. Non-syndromic cleft lip and/or cleft palate: epidemiology and risk factors in Lubumbashi (DR Congo), a case-control study. J Craniomaxillofac Surg 2018; 46 (07) 1051-1058
  • 3 Cooper ME, Ratay JS, Marazita ML. Asian oral-facial cleft birth prevalence. Cleft Palate Craniofac J 2006; 43 (05) 580-589
  • 4 Xu LF, Zhou XL, Wang Q. et al. A case-control study of environmental risk factors for nonsyndromic cleft of the lip and/or palate in Xuzhou, China. Biomed Environ Sci 2015; 28 (07) 535-538
  • 5 Fan D, Wu S, Liu L. et al. Prevalence of non-syndromic orofacial clefts: based on 15,094,978 Chinese perinatal infants. Oncotarget 2018; 9 (17) 13981-13990
  • 6 Worley ML, Patel KG, Kilpatrick LA. Cleft lip and palate. Clin Perinatol 2018; 45 (04) 661-678
  • 7 Molina-Solana R, Yáñez-Vico RM, Iglesias-Linares A, Mendoza-Mendoza A, Solano-Reina E. Current concepts on the effect of environmental factors on cleft lip and palate. Int J Oral Maxillofac Implants 2013; 42 (02) 177-184
  • 8 Cobourne MT. The complex genetics of cleft lip and palate. Eur J Orthod 2004; 26 (01) 7-16
  • 9 Sabbagh HJ, Alamoudi NM, Abdulhameed FD. et al. Environmental risk factors in the etiology of non-syndromic orofacial clefts in the western region of Saudi Arabia. Cleft Palate Craniofac J 2016; 53 (04) 435-443
  • 10 Setó-Salvia N, Stanier P. Genetics of cleft lip and/or cleft palate: association with other common anomalies. Eur J Med Genet 2014; 57 (08) 381-393
  • 11 Butali A, Little J, Chevrier C. et al. Folic acid supplementation use and the MTHFR C677T polymorphism in orofacial clefts etiology: an individual participant data pooled-analysis. Birth Defects Res A Clin Mol Teratol 2013; 97 (08) 509-514
  • 12 Wehby GL, Cassell CH. The impact of orofacial clefts on quality of life and healthcare use and costs. Oral Dis 2010; 16 (01) 3-10
  • 13 Bezerra JF, Oliveira GHM, Soares CD. et al. Genetic and non-genetic factors that increase the risk of non-syndromic cleft lip and/or palate development. Oral Dis 2015; 21 (03) 393-399
  • 14 Shaye D, Liu CC, Tollefson TT. Cleft lip and palate: an evidence-based review. Facial Plast Surg Clin North Am 2015; 23 (03) 357-372
  • 15 Kummer AW. Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance. United States: Thomson Delmar Learning; 2013
  • 16 Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet 2011; 12 (03) 167-178
  • 17 Stanier P, Moore GE. Genetics of cleft lip and palate: syndromic genes contribute to the incidence of non-syndromic clefts. Hum Mol Genet 2004; 13 (Spec No 1): R73-R81
  • 18 Andersson L, Erik KK. eds. Oral and Maxillofacial Surgery. 1st ed. Wiley_Blackwell; 2010
  • 19 Burg ML, Chai Y, Yao CA, Magee III W, Figueiredo JC. Epidemiology, etiology, and treatment of isolated cleft palate. Front Physiol 2016; 7 (MAR): 67
  • 20 Tayebi N, Yazdani K, Naghshin N. The prevalence of congenital malformations and its correlation with consanguineous marriages. Oman Med J 2010; 25 (01) 37-40
  • 21 Mirilas P, Mentessidou A, Kontis E. et al. Parental exposures and risk of nonsyndromic orofacial clefts in offspring: a case-control study in Greece. Int J Pediatr Otorhinolaryngol 2011; 75 (05) 695-699
  • 22 Lin Y, Shu S, Tang S. A case-control study of environmental exposures for non-syndromic cleft of the lip and/or palate in eastern Guangdong, China. Int J Pediatr Otorhinolaryngol 2014; 78 (03) 545-551
  • 23 Xu MY, Deng XL, Tata LJ. et al. Case-control and family-based association studies of novel susceptibility locus 8q24 in nonsyndromic cleft lip with or without cleft palate in a Southern Han Chinese population located in Guangdong Province. DNA Cell Biol 2012; 31 (05) 700-705
  • 24 Jamilian A, Sarkarat F, Jafari M. et al. Family history and risk factors for cleft lip and palate patients and their associated anomalies. Stomatologija 2017; 19 (03) 78-83
  • 25 Stuppia L, Capogreco M, Marzo G. et al. Genetics of syndromic and nonsyndromic cleft lip and palate. J Craniofac Surg 2011; 22 (05) 1722-1726
  • 26 Acuña-González G, Medina-Solís CE, Maupomé G. et al. Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: a matched case-control study in a less developed country. Biomédica 2011; 31 (03) 381-391
  • 27 Tanaka SA, Mahabir RC, Jupiter DC, Menezes JM. Updating the epidemiology of cleft lip with or without cleft palate. Plast Reconstr Surg 2012; 129 (03) 511e-518e
  • 28 Nahas LD, Alzamel O, Dali MY. et al. Distribution and risk factors of cleft lip and palate on patients from a sample of Damascus hospitals - a case-control study. Heliyon 2021; 7 (09) e07957
  • 29 Leslie EJ, Marazita ML. Genetics of cleft lip and cleft palate. Am J Med Genet C Semin Med Genet 2013; 163C (04) 246-258
  • 30 McKinney CM, Pisek A, Chowchuen B. et al. Case-control study of nutritional and environmental factors and the risk of oral clefts in Thailand. Birth Defects Res A Clin Mol Teratol 2016; 106 (07) 624-632
  • 31 De R. Risk factors associated with non-syndromic oral clefts in a Brazilian population: a case-control study. Rev Odontol UNESP 2012; 41 (03) 203-208
  • 32 Hong Y, Xu X, Lian F, Chen R. Environmental risk factors for nonsyndromic cleft lip and/or cleft palate in Xinjiang Province, China: a multiethnic study. Cleft Palate Craniofac J 2021; 58 (04) 489-496
  • 33 Auslander A, McKean-Cowdin R, Brindopke F. et al; Operation Smile International Family Study Group*. The role of smoke from cooking indoors over an open flame and parental smoking on the risk of cleft lip and palate: a case- control study in 7 low-resource countries. J Glob Health 2020; 10 (02) 020410
  • 34 Zhang B, Jiao X, Mao L, Xue J. Maternal cigarette smoking and the associated risk of having a child with orofacial clefts in China: a case-control study. J Craniomaxillofac Surg 2011; 39 (05) 313-318
  • 35 Taghavi N, Mollaian M, Alizadeh P, Moshref M, Modabernia Sh, Akbarzadeh AR. Orofacial clefts and risk factors in Tehran, Iran: a case control study. Iran Red Crescent Med J 2012; 14 (01) 25-30
  • 36 Ravichandran K, Shoukri M, Aljohar A, Shazia NS, Al-Twaijri Y, Al Jarba I. Consanguinity and occurrence of cleft lip/palate: a hospital-based registry study in Riyadh. Am J Med Genet A 2012; 158A (03) 541-546
  • 37 Jose B, Jayan M, Subramani S, Mokhasi V. Consanguinity and clefts in the craniofacial region: a retrospective case-control study. J Cleft Lip Palate Craniofacial Anomalies 2015; 2 (02) 113
  • 38 Hadadi AI, Al Wohaibi D, Almtrok N, Aljahdali N, AlMeshal O, Badri M. Congenital anomalies associated with syndromic and non-syndromic cleft lip and palate. JPRAS Open 2017; 14: 5-15
  • 39 Inchingolo AM, Fatone MC, Malcangi G. et al. Modifiable risk factors of non-syndromic orofacial clefts: a systematic review. Children (Basel) 2022; 9 (12) 1-24
  • 40 Kapos FP, White LA, Schmidt KA, Hawes SE, Starr JR. Risk of non-syndromic orofacial clefts by maternal rural-urban residence and race/ethnicity: a population-based case-control study in Washington State 1989-2014. Paediatr Perinat Epidemiol 2021; 35 (03) 292-301
  • 41 Maia C, Carolina M, Pereira DM, Bernardes T, Queiroz D. Early human development can parental consanguinity be a risk factor for the occurrence of non-syndromic oral cleft?. Early Hum Dev 2019; 135 (May): 23-26
  • 42 Ly S, Burg ML, Ihenacho U. et al. Paternal risk factors for oral clefts in Northern Africans, Southeast Asians, and Central Americans. Int J Environ Res Public Health 2017; 14 (06) 657
  • 43 Maranhão SC, Sá J, Cangussú MCT, Coletta RD, Reis SRA, Medrado ARAP. Nonsyndromic oral clefts and associated risk factors in the state of Bahia, Brazil. Eur Arch Paediatr Dent 2021; 22 (02) 121-127
  • 44 Hao Y, Tian S, Jiao X. et al. Association of parental environmental exposures and supplementation intake with risk of non-syndromic orofacial clefts: a case-control study in Heilongjiang Province, China. Nutrients 2015; 7 (09) 7172-7184
  • 45 Rao A, Ahmed MK, Taub PJ, Mamoun JS. The correlation between maternal exposure to air pollution and the risk of orofacial clefts in infants: a systematic review and meta-analysis. J Oral Maxillofac Res 2016; 7 (01) e2
  • 46 Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a meta-analysis. Bull World Health Organ 2004; 82 (03) 213-218
  • 47 Golalipour MJ, Kaviany N, Qorbani M, Mobasheri E. Maternal risk factors for oral clefts: a case-control study. Iran J Otorhinolaryngol 2012; 24 (69) 187-192
  • 48 Sabbagh HJ, Hassan MHA, Innes NPT, Elkodary HM, Little J, Mossey PA. Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis. PLoS One 2015; 10 (03) e0116963
  • 49 Sugiyono PD. ed. Qualitative, Quantitative Research Methods and R&D. 19th ed. Bandung: Alfabeta; 2013
  • 50 DeRoo LA, Wilcox AJ, Lie RT. et al. Maternal alcohol binge-drinking in the first trimester and the risk of orofacial clefts in offspring: a large population-based pooling study. Eur J Epidemiol 2016; 31 (10) 1021-1034
  • 51 Boyles AL, DeRoo LA, Lie RT. et al. Maternal alcohol consumption, alcohol metabolism genes, and the risk of oral clefts: a population-based case-control study in Norway, 1996-2001. Am J Epidemiol 2010; 172 (08) 924-931
  • 52 Neogi SB, Singh S, Pallepogula DR. et al. Risk factors for orofacial clefts in India: a case-control study. Birth Defects Res 2017; 109 (16) 1284-1291
  • 53 Zhang B, Jiao X, Mao L. et al. Maternal alcohol consumption, alcohol metabolism genes, and the risk of oral clefts: a population-based case-control study in Norway, 1996–2001. Int J Pediatr Otorhinolaryngol 2011; 10 (03) 695-699