Abstract：
The most common congenital anomaly is orofacial cleft, which is categorized into two main types: cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). One of the most accepted etiologies is multifactorial (gene-environment). This study aimed to identify the amendable risk factors of an orofacial cleft in Northern Thailand. A retrospective case-control study in Maharaj Nakorn Chiang Mai Hospital was conducted from 2011 to 2020. One hundred and seventeen cases of CL/P and CPO were included. Forty-nine normal children were enrolled in a time-matched control group. Exploratory survey data on maternal exposures were collected. Multivariate logistic regression was used to estimate the adjusted association between maternal exposures and CL/P, and CPO occurrence. Multivariate analysis identified three predisposing factors that increased the risk of CL/P and CPO. The first factor was caffeine consumption with a total amount of 560 mg/week (adjusted OR: 7.59; 95% CI: 2.48-23.23; p < 0.001). The second factor was any smoker or passive smoking (adjusted OR: 8.47; 95% CI: 1.63-43.92; p = 0.011). The third factor was a low socioeconomic status (income of lower than 270 USD/month; adjusted OR: 4.05; 95% CI: 1.07-15.27; p = 0.039). From the 10-year study in Northern Thailand: caffeine consumption, exposure to cigarette smoke, and low socioeconomic status were identified as associated negative factors for orofacial clefts. We propose that preconceptional counseling for risk reduction should be emphasized in reducing the mother\'s exposure to these factors. Future investigations in large multicenter populations are suggested.
摘要：
最常见的先天性异常是口面裂,分为两种主要类型：唇裂伴或不伴left裂（CL/P）和仅left裂（CPO）。最被接受的病因之一是多因素(基因-环境)。本研究旨在确定泰国北部口面裂的可修正危险因素。2011年至2020年在清迈MaharajNakorn医院进行了回顾性病例对照研究。纳入了117例CL/P和CPO。49名正常儿童被纳入时间匹配的对照组。收集了有关孕产妇暴露的探索性调查数据。使用多变量逻辑回归来估计母体暴露与CL/P之间的校正关联。和CPO发生。多变量分析确定了增加CL/P和CPO风险的三个易感因素。第一个因素是咖啡因摄入量，总量为560毫克/周（校正OR：7.59;95％CI：2.48-23.23;p<0.001）。第二个因素是任何吸烟者或被动吸烟（校正OR：8.47;95％CI：1.63-43.92;p=0.011）。第三个因素是低社会经济地位（收入低于270美元/月；调整后的OR：4.05；95％CI：1.07-15.27；p=0.039）。来自泰国北部的10年研究：咖啡因消费，接触香烟烟雾，低社会经济地位被确定为口面裂痕的相关负面因素。我们建议在减少母亲对这些因素的暴露时，应强调降低风险的先入为主的咨询。建议在大型多中心人群中进行未来调查。
