Association between maternal periconceptional dietary patterns and occurrence of orofacial clefts

Orofacial clefts (OFC) are a common birth defect with few known risk factors (eg, smoking). Maternal diet is associated with birth defects, though the relationship with OFC is less clear as studies typically only investigate single nutrients. We assessed the association between periconceptional maternal diet and OFC in the United States, using the National Birth Defects Prevention Study (1997-2011), including 3649 cases (2480 cleft lip with/without palate [CL/P] and 1169 cleft palate [CP]) and 10 584 controls (infants without a birth defect). Using latent class analysis, we derived dietary patterns based on relative consumption of self-reported food items via food frequency data. We used logistic regression to estimate adjusted odds ratios (aORs) and 95% CIs for the effect of dietary patterns on OFC. Four patterns were identified: Prudent (reference), Western, Low-Calorie Western, and Mexican. The Western diet had increased odds of CL/P (aOR: 1.3 [95% CI, 1.2-1.5]) and CP (aOR: 1.2 [95% CI, 1.1-1.4]). Low-Calorie Western (CL/P aOR: 1.2 [95% CI, 1.0-1.4]; CP aOR: 1.0 [95% CI, 0.9-1.2]) and Mexican diets (CL/P aOR: 1.1 [95% CI, 0.9-1.3]; CP aOR: 0.8 [95% CI, 0.6-1.1]) had a weaker or null association. Findings underscore the importance of further investigation into the effect of periconceptional diet on OFC occurrence.