Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, 600077, India.
BMC Oral Health. 2024 Feb 5;24(1):185. doi: 10.1186/s12903-024-03884-9.
The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive.
A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI).
The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations.
The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development.
本研究旨在通过系统评价和荟萃分析，综合现有证据，探讨孕妇可卡因滥用与子代唇腭裂（CL/P）患病率之间的关系。CL/P 是一种先天性颅面畸形，其病因复杂，先前的研究表明，母体可卡因使用与 CL/P 之间存在潜在关联。然而，这些关联仍存在争议。
系统检索了截至 2021 年 9 月研究截止日期发表的相关研究。使用预定义的检索词对多个数据库进行了系统检索。纳入标准为报告母亲孕期可卡因使用史与非可卡因使用母亲的婴儿 CL/P 患病率的研究，比较组为非可卡因使用母亲。提取数据，并使用随机效应模型进行荟萃分析，计算汇总优势比（OR）和相对风险（RR）及其各自的 95%置信区间（CI）。
本综述纳入了 4 项符合纳入标准的研究的数据。两项研究的合并 OR 为 0.05（95%CI：0.00，4.41），由于置信区间跨越零值，这并不表明产前可卡因暴露与 CL/P 发生率之间存在统计学显著关联。此外，合并 RR 为 0.17（95%CI：0.04，0.66），表明产前可卡因暴露与 CL/P 风险降低相关，具有统计学意义。由于纳入研究结果的异质性和变异性较大，这些结果，即 OR 不具有统计学意义，RR 提示风险降低，应谨慎解释。需要进一步研究以阐明这些关联。
本系统评价和荟萃分析的结果表明，孕妇孕期可卡因使用不是 CL/P 子代发生的统计学显著独立危险因素。这些结果强调了 CL/P 病因的多因素性质，并强调了在理解该病症起源时考虑其他遗传、环境和营养因素的重要性。虽然该研究提供了重要的见解，但应认识到数据异质性和潜在混杂因素的局限性。未来的研究应采用严格的研究设计，并探索更广泛的潜在风险因素，以全面阐明 CL/P 的发病机制。
