Neighborhood-based socioeconomic position and risk of oral clefts among offspring

Abstract

Objectives. We determined the association between maternal neighborhood socioeconomic position (SEP) and the risk of cleft lip with or without cleft palate (CL +/- P) or cleft palate alone (CP) in offspring.

Methods. We obtained information on CL +/- P (n = 2555) and CP (n = 1112) cases and unaffected controls (n = 14 735) among infants delivered during 1999 to 2008 from the Texas Birth Defects Registry. Neighborhood SEP variables, drawn from the 2000 US Census, included census tract-level poverty, education, unemployment, occupation, housing, and crowding, from which we created a composite neighborhood deprivation index (NDI). We used mixed-effects logistic regression to evaluate neighborhood SEP and oral clefts.

Results. Mothers with CL +/- P-affected offspring were more likely to live in high-NDI (adverse) areas than mothers with unaffected offspring (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.05, 1.37). This association was strongest among Hispanic mothers (OR = 1.32, 95% CI = 1.07, 1.62). No associations were observed with CP.

Conclusions. Using data from one of the world's largest active surveillance birth defects registries, we found that adverse neighborhood SEP is modestly associated with CL +/- P, especially among Hispanics. These findings may have important implications for health disparities prevention.