MATERNAL ALCOHOL-USE AND RISK OF OROFACIAL CLEFT BIRTH-DEFECTS

Maternal alcohol use during pregnancy is a known cause of birth defect s associated with the fetal alcohol syndrome, but its role in more com mon, isolated, craniofacial birth defects is not well understood. A po pulation-based, case-control study of orofacial clefts was conducted i n Iowa using births during 1987-1991. Cases were identified by the Iow a Birth Defects Registry and classified as having a cleft lip with or without cleft palate (CIP) or cleft palate only (CP) and whether the c left was isolated or occurred with other birth defects. Controls were selected from normal Iowa births. Maternal alcohol use during pregnanc y was classified according to self-reported drinks consumed per month. Results are based on 302 controls and the following numbers in each c ase group: 118 isolated CLP, 56 isolated CP, 51 CLP with multiple defe cts, and 62 CP with multiple defects. Compared to women who did not dr ink alcohol during pregnancy, the relative odds of isolated CLP rose w ith increasing level of maternal drinking as follows: 1-3 drinks per m onths, 1.5; 4-10 drinks per month, 3.1; more than 10 drinks per month, 4.7 (chi-square test for trend, P = 0.003). Adjustment for maternal s moking, vitamin use, education, and household income did not substanti ally alter these results. No significant association was found between alcohol use and isolated cleft palate or clefts in children with mult iple birth defects. Alcohol use during pregnancy may be a cause of iso lated cleft lip with or without cleft palate. (C) 1996 Wiley-Liss, Inc .