Online Program

Environmental factors and risk of orofacial clefts in the democratic republic of congo

Wednesday, November 6, 2013

Ugonna Ihenacho, MPH, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
Stephanie Ly, MPH, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
Haley Marie Raimondi, MA, Operation Smile, Inc., Norfolk, VA
William Magee III, MD, DDS, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA
Kathleen Magee, MEd, MSW, Operation Smile, Inc., Virginia Beach, VA
Jane Figueiredo, PhD, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
Orofacial clefts are among the most common birth defects in the world. Etiology of cleft lips and palates has not been extensively studied and are primarily based in higher income countries and the Caucasian population. The University of Southern California in partnership with Operation Smile is investigating genetic and environmental factors in the etiology of clefts. Cases defined as children with clefts were enrolled during an Operation Smile surgical mission in Kinshasa, the Democratic Republic of Congo (DRC) along with their biological parents. Controls defined as non-cleft newborns and their biological parents were recruited from local maternity wards. Self-reported questionnaires were administered by local translators to mothers containing questions about environmental factors, prenatal behaviors and lifestyle factors. Multivariate logistic regression analysis shows an increased risk of orofacial cleft was associated with living in a rural area during pregnancy (p=0.0004; OR 16.6; 95% CI 1.86-148.1) and marginally associated with living on a farm during pregnancy (p=0.081; OR 7.6; 95% CI 0.78-74.1). A decreased risk of orofacial cleft was associated with consuming public water during pregnancy (p=0.006; OR 0.37; 95% CI 0.18-0.75). These findings suggest that women in rural areas and environmental exposures may contribute to the etiology of this congenital abnormality. The protective nature of public drinking water reveals an area that should be considered in future studies and analyzed further. With additional studies on maternal exposures in DRC, preventive measures may be implemented to reduce the incidence of orofacial clefts.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Environmental health sciences
Public health or related research

Learning Objectives:
Discuss the need for further study of environmental risk factors Identify environmental factors associated with orofacial clefts in the Democratic Republic of Congo

Keyword(s): Environmental Exposures, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in public health and have presented at conferences
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.