Itikala P R, Watkins M L, Mulinare J, Moore C A, Liu Y
DBDCDDH, NCEH, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Teratology. 2001 Feb;63(2):79-86. doi: 10.1002/1096-9926(200102)63:2<79::AID-TERA1013>3.0.CO;2-3.
Cleft lip with or without cleft palate (CLP) and cleft palate alone (CP) affect approximately 1 in 1000 infants and 1 in 2,500 infants, respectively. Studies of the relation between orofacial clefts and multivitamins or folic acid have been inconsistent.
We used data from a population-based case-control study involving 309 nonsyndromic cleft-affected births (222 with CLP, 87 with CP) and 3,029 control births from 1968 to 1980 to evaluate the relation between regular multivitamin use and the birth prevalence of orofacial clefts.
We found a 48% risk reduction for CLP (odds ratio = 0.52, 95% confidence interval = 0.34-0.80) among mothers who used multivitamins during the periconceptional period or who started multivitamin use during the first postconceptional month, after controlling for several covariates. The risk reduction for CP was less than those for CLP (odds ratio = 0.81, 95% confidence interval = 0.44-1.52); however, a small number of CP cases limited interpretation. No risk reductions for CLP or CP were found for women who began multivitamin use in the second or third month after conception.
The magnitude of the risk reduction in our study is comparable to those of other recent studies; our study does not support the contention that only large dosages of folic acid are needed to prevent orofacial clefts. More studies are needed to test the effects of multivitamins and varying dosages of folic acid on the recurrence and/or occurrence of orofacial clefts to provide information needed to determine possible prevention strategies. Published 2001 Wiley-Liss, Inc.
唇裂伴或不伴腭裂（CLP）和单纯腭裂（CP）分别影响约千分之一的婴儿和两千五百分之一的婴儿。关于口面部裂隙与多种维生素或叶酸之间关系的研究结果并不一致。
我们使用了一项基于人群的病例对照研究的数据，该研究涉及1968年至1980年的309例非综合征性腭裂出生病例（222例CLP，87例CP）和3029例对照出生病例，以评估常规使用多种维生素与口面部裂隙出生患病率之间的关系。
在控制了几个协变量后，我们发现，在受孕期间使用多种维生素或在受孕后第一个月开始使用多种维生素的母亲中，CLP的风险降低了48%（优势比=0.52，95%置信区间=0.34-0.80）。CP的风险降低幅度小于CLP（优势比=0.81，95%置信区间=0.44-1.52）；然而，CP病例数量较少，限制了对结果的解释。对于在受孕后第二个月或第三个月开始使用多种维生素的女性，未发现CLP或CP的风险降低。
我们研究中风险降低的幅度与其他近期研究相当；我们的研究不支持仅需要大剂量叶酸来预防口面部裂隙的观点。需要更多的研究来测试多种维生素和不同剂量叶酸对口面部裂隙复发和/或发生的影响，以提供确定可能预防策略所需的信息。2001年由Wiley-Liss公司出版。
