Isolated cleft palate (CPO) is the rarest form of oral clefting affecting 1-25 per
10 000 newborns worldwide. There is increasing evidence for the different pathogenetic
backgrounds of CPO and cleft lip with or without cleft palate. The role of environmental
factors in the origin of non-syndromic and syndromic CPO is unclear in most patients.
The aim of this study was to estimate possible maternal risk factors in the origin
of CPO.The Hungarian Case-Control Surveillance of Congenital Abnormalities contains
data of 32 345 birth defect cases and 57 231 control newborns. The study samples included
751 cases with isolated CPO, 1196 matched controls and 57 231 population controls.Maternal
diseases during pregnancy in cases and population controls were compared, and adjusted
ORs with 95% CI were calculated in a multivariable unconditional logistic regression
model.Beyond the well-known robust female excess (58.9%)-maternal smoking (OR with
95% CI: 2.34, 1.94-2.81) medically recorded maternal anaemia, threatened abortion
and excessive vomiting in pregnancy were associated with a higher risk for CPO in
the offspring. An elevated risk was found in Graves' disease (OR: 4.30, 1.74-10.62),
epilepsy (OR: 4.64, 2.44-8.82), migraine (OR: 2.82, 1.18-6.76) and essential hypertension
(OR: 2.33, 1.32-4.10). Among acute diseases common cold (OR: 4.94, 3.48-7.03), acute
respiratory infections (OR: 4.20, 1.49-11.82), influenza (OR: 2.95, 1.75-4.95), pulpitis
(OR: 7.85, 2.80-22.03), cholecystitis (OR: 3.15, 1.16-8.60), acute urinary tract infections
(OR: 4.08, 2.22-7.49) and pelvic inflammatory diseases (OR: 3.93, 1.62-9.53) during
pregnancy also were associated with an increased risk for developing CPO.The findings
of this study suggest that maternal diseases and lifestyle factors during the first
trimester play a significant role in the development of isolated cleft palate.
