Pre-eclampsia ups risk of nonsyndromic orofacial clefts

Only pre-eclampsia, among other hypertensive disorders of pregnancy, contributes to a higher risk of nonsyndromic orofacial clefts (NSOFCs) and its subtypes, a study has found.

“The associations between hypertensive disorders of pregnancy and are not consistent or based on case–control study design,” the investigators said. “We hypothesize that OFCs and NSOFCs are associated with hypertensive disease in pregnancy.”

In this study, the investigators obtained data from the Project for Neural Tube Defects Prevention (1993‒1996), a large population-based cohort study conducted in two southern provinces of China. They recorded all births after 20 complete gestational weeks, including live births and stillbirths, and all structural congenital anomalies regardless of gestational week.

Overall, 200,215 singleton live births with no external birth defects were included in the analysis. NSOFC incidence stood at 20.2 per 10,000 for the whole population, and 20.5 and 39.2 per 10,000 for women with gestational hypertension and pre-eclampsia, respectively.

Women with pre-eclampsia, compared to those without, had a higher risk of giving birth to infants with NSOFCs (adjusted risk ratio [aRR], 2.02, 95 percent confidence interval [CI], 1.27‒3.20), cleft lip with or without cleft palate (aRR, 2.24, 95 percent CI, 1.37‒3.65), and cleft lip and palate (aRR, 2.60, 95 percent CI, 1.45‒4.67), but not cleft lip only (aRR, 1.66, 95 percent CI, 0.68‒4.08) or cleft palate only (aRR, 1.09, 95 percent CI, 0.27‒4.45).

In addition, no associations were found between gestational hypertension and any types of NSOFCs.