Loffredo L C, Souza J M, Freitas J A, Mossey P A
UNESP-Faculdade de Odontologia de Araraquara, Brazil.
Cleft Palate Craniofac J. 2001 Jan;38(1):76-83. doi: 10.1597/1545-1569_2001_038_0076_ocavs_2.0.co_2.
The evidence linking low levels of folic acid and orofacial clefting (OFC) is presently equivocal. There is stronger evidence for the role of folic acid supplementation in protection against the occurrence and recurrence of neural tube defects. The present investigation tested the hypotheses that cleft lip, cleft palate, or both are inversely associated with maternal intake of dietary and supplemental vitamins during the periconceptional period and first 4 months of pregnancy in a Brazilian population.
A population-based, case-control study of cleft lip with or without cleft palate (CL(P)) and isolated cleft palate (CP) in a Brazilian population. In structured interviews, case histories were taken from the mothers of a consecutive sample of 450 infants born with nonsyndromic OFC.
Mothers who had children with CL(P) were less likely to have been supplemented during the periconceptional period. The statistical significance of the difference in prevalence of the use of supplements between mothers of patients and of controls was greater for the CL(P) group: p < .05 for CP and p < .001 for CL(P). Multivariate analysis confirmed this finding of a protective effect for both types of orofacial cleft.
The use of vitamin supplements in the first 4 months of pregnancy was suggestive of a protective effect against the occurrence of CP and CL(P) in this population. The significance of an association between multivitamin supplementation and OFC and the possible role of gene/environment interaction are discussed.
目前，低水平叶酸与口面部裂隙（OFC）之间的联系证据尚不明确。有更强的证据表明补充叶酸在预防神经管缺陷的发生和复发中发挥作用。本研究检验了以下假设：在巴西人群中，唇裂、腭裂或两者同时出现与孕期前和怀孕头4个月母亲的膳食和补充维生素摄入量呈负相关。
一项基于人群的巴西唇裂伴或不伴腭裂（CL(P)）和孤立性腭裂（CP）病例对照研究。在结构化访谈中，对450例非综合征性OFC患儿的母亲进行了连续抽样病史采集。
患有CL(P)患儿的母亲在孕期前接受补充剂的可能性较小。患者母亲和对照母亲补充剂使用患病率差异的统计学显著性在CL(P)组更大：CP组p <.05，CL(P)组p <.001。多变量分析证实了这一针对两种口面部裂隙的保护作用的发现。
在怀孕的头4个月使用维生素补充剂提示对该人群中CP和CL(P)的发生有保护作用。讨论了多种维生素补充剂与OFC之间关联的意义以及基因/环境相互作用的可能作用。
