ABSTRACT
Background: The multifactorial etiology of clefts includes both genetic and environmental factors. Many studieswere conducted to identify the genetic basis of the etiology of clefts and effect of maternal folic acid intake inreducing the risk of clefts.. Not many studies conducted about other environmental factors causing clefts. Thepresent study is to find out the non-genetic factors associated with the nonsyndromic clefts. The maternalpericonceptional intake of folic acid, family history, parental age, socioeconomic status, parental alcoholismand smoking, and parental occupational exposure are the factors included in the study.Materials and methods: The study group comprised 400 subjects with 200 Nonsyndromic cleft cases and 200healthy controls from the South Indian population. The data was collected in a detailed questionnaire by directinterview and analyzed the data using SPSS version 21. Logistic regression model was used to measure the oddsratio(OR) for the independent variables and Chi- square analysis was performed to find out the significance.Results: The family history of clefts was found in 10.6% cleft cases (p value= 0.001). The risk of cleft wasincreased in cases with no maternal folic acid intake in their first trimester of pregnancy (p value= 0.001).Parental age more than 35 years (p value= 0.004) and low maternal education (p value= 0.001) were also foundas the risk factors to cleft. Low socioeconomic background was another risk factor (p value= 0.001). Parentaloccupational exposure in terms of pestcidal exposure was found significant but not the parental medicationand smoking.Conclusion: Maternal consumption of folic acid and multivitamins during the periconceptional period to beassured to prevent the occurrence of oral clefts. Family history of cleft increases the risk of cleft and the risk isfurther increased when cleft is present in parents or siblings. And maternal age more than 35 years is foundmore significant than the paternal age . Consanguinity showed 4 fold increase in clefts. Maternal diet is a primefactor as it is directly related to folic acid and vitamin supplementation apart from the socioeconomic status offamily