The averaged incidences of nonsyndromal/isolated cleft lip (CL), cleft palate (CP), and cleft lip with cleft palate (CLCP) by each month-of-conception, and managed in our hospital in from 2002 to 2009 were correlated with the reported levels of sunshine, ultraviolet radiation, and ambient nitrogen oxides (nitrogen oxide, nitrogen monoxide, and nitrogen dioxide), sulfur dioxide, and ozone, at the month of, and then at 4 and 8 weeks after, conception. There were 25, 12, and 22 cases each of CL, CP, and CLCP, respectively, totaling 59 cases (1.21 of 1000 births). On regression analysis, sunshine correlated inversely with the isolated CL at (P = .009) 4 weeks (P = .005) and 8 weeks (P = .008) postconception, and with CP (P = .009) and CLCP (P < .001) at 8 weeks postconception, while NOx correlated inversely with CL (P = .018) and NO with CLCP (P = .031), at 8 weeks postconception. Our results suggested that the interaction between sunshine and nitrogen oxides with other factors results in the reported seasonal variation in the incidence of isolated oral-facial clefts.
MosseyPALittleJMungerRGDixonMJShawWC. Cleft lip and palate. Lancet. 2009;374(9703):1773–1785.
2.
LittleJCardyAArslanMTGilmourMMosseyPA. Smoking and orofacial clefts: a United Kingdom-based case-control study. Cleft Palate Craniofac J. 2004;41(4):381–386.
3.
RomittiPASunLHoneinMAReefhuisJCorreaARasmussenSA. Maternal periconceptional alcohol consumption and risk of orofacial clefts. Am J Epidemiol. 2007;166(7):775–785.
4.
MeyerKAWerlerMMHayesCMitchellAA. Low maternal alcohol consumption during pregnancy and oral clefts in offspring: the Slone Birth Defects Study. Birth Defects Res A Clin Mol Teratol. 2003;67(7):509–514.
5.
CooperMERatayJSMarazitaML. Asian oral-facial cleft birth prevalence. Cleft Palate Craniofac J. 2006;43(5):580–589.
6.
CouplandMACouplandAI. Seasonality, incidence, and sex distribution of cleft lip and palate births in Trent Region, 1973-1982. Cleft Palate J. 1988;25(1):33–37.
7.
De la VegaALopez-CeperoR. Seasonal variations in the incidence of some congenital anomalies in Puerto Rico based on the timing of conception. P R Health Sci J. 2009;28(2):121–125.
8.
ElliottRFJovicGBeveridgeM. Seasonal variation and regional distribution of cleft lip and palate in Zambia. Cleft Palate Craniofac J. 2008;45(5):533–538.
9.
FraserFCGwynA. Seasonal variation in birth date of children with cleft lip. Teratology. 1998;57(2):93–95.
10.
KrostBSchubertJ. Influence of season on prevalence of cleft lip and palate. Int J Oral Maxillofac Surg. 2006;35(3):215–218.
11.
Vallino-NapoliLDRileyMMHallidayJ.An epidemiologic study of isolated cleft lip, palate, or both in Victoria, Australia from 1983 to 2000. Cleft Palate Craniofac J. 2004;41(2):185–194.
12.
ChungMKLaoTTTingYHSuenSHLeungTYLauTK.Is there seasonality in the incidence of oral-facial clefts?J Matern Fetal Neonatal Med. 2011;1(14).
13.
CroenLAShawGMWassermanCRTolarovaMM. Racial and ethnic variations in the prevalence of orofacial clefts in California, 1983-1992. Am J Med Genet. 1998;79(1):42–47.
14.
ChuangsuwanichAAojanepongCMuangsombutSTongpiewP. Epidemiology of cleft lip and palate in Thailand. Ann Plast Surg. 1998;41(1):7–10.
15.
KimSKimWJOhCKimJC. Cleft lip and palate incidence among the live births in the Republic of Korea. J Korean Med Sci. 2002;17(1):49–52.
16.
NatsumeNKawaiTKohamaGIncidence of cleft lip or palate in 303738 Japanese babies born between 1994 and 1995. Br J Oral Maxillofac Surg. 2000;38(6):605–607.
17.
LaumonBMartinJLColletPBertucatIVerneyMPRobertE. Exposure to organic solvents during pregnancy and oral clefts: a case-control study. Reprod Toxicol. 1996;10(1):15–19.
18.
NurminenTRantalaKKurppaKHolmbergPC. Agricultural work during pregnancy and selected structural malformations in Finland. Epidemiology. 1995;6(1):23–30.
19.
SperberG. Formation of the primary and secondary palate. In: WyszynskiD, ed. Cleft Lip and Palate: From Origin to Treatment. New York, NY: Oxford University Press; 2002:5–24.
20.
LumleyJ. Defining the problem: the epidemiology of preterm birth. BJOG. 2003;110(suppl 20):3–7.
21.
BellMLEbisuKBelangerK. Ambient air pollution and low birth weight in Connecticut and Massachusetts. Environ Health Perspect. 2007;115(7):1118–1124.
22.
LeeBEHaEHParkHSExposure to air pollution during different gestational phases contributes to risks of low birth weight. Hum Reprod. 2003;18(3):638–643.
23.
BrauerMLencarCTamburicLKoehoornMDemersPKarrC. A cohort study of traffic-related air pollution impacts on birth outcomes. Environ Health Perspect. 2008;116(5):680–686.
24.
MarozieneLGrazulevicieneR. Maternal exposure to low-level air pollution and pregnancy outcomes: a population-based study. Environ Health. 2002;1(1):6.
25.
XuXDingHWangX. Acute effects of total suspended particles and sulfur dioxides on preterm delivery: a community-based cohort study. Arch Environ Health. 1995;50(6):407–415.
26.
HuynhMWoodruffTJParkerJDSchoendorfKC. Relationships between air pollution and preterm birth in California. Paediatr Perinat Epidemiol. 2006;20(6):454–461.
27.
RitzBYuFChapaGFruinS. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 2000;11(5):502–511.
28.
DolkHArmstrongBLachowyczKAmbient air pollution and risk of congenital anomalies in England, 1991-1999. Occup Environ Med. 2010;67(4):223–227.
29.
HughesMN. Chemistry of nitric oxide and related species. Methods Enzymol. 2008;436:3–19.
30.
SuzukiTNagamatsuCKushimaTApoptosis caused by an inhibitor of NO production in the decidua of rat from mid-gestation. Exp Biol Med (Maywood). 2010;235(4):455–462.
31.
ValkoMLeibfritzDMoncolJCroninMTMazurMTelserJ. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol. 2007;39(1):44–84.
32.
CordierSChevrierCRobert-GnansiaELorenteCBrulaPHoursM. Risk of congenital anomalies in the vicinity of municipal solid waste incinerators. Occup Environ Med. 2004;61(1):8–15.
33.
HwangBFJaakkolaJJ. Ozone and other air pollutants and the risk of oral clefts. Environ Health Perspect. 2008;116(10):1411–1415.
34.
RosselliMKellerPJDubeyRK. Role of nitric oxide in the biology, physiology and pathophysiology of reproduction. Hum Reprod Update. 1998;4(1):3–24.
35.
BergendiLBenesLDurackovaZFerencikM. Chemistry, physiology and pathology of free radicals. Life Sci. 1999;65(18-19):1865–1874.
36.
ChiuehCC. Neuroprotective properties of nitric oxide. Ann N Y Acad Sci. 1999;890:301–311.
37.
BarutAHarmaMArikanIHarmaMIBarutF. Endothelial nitric oxide synthase expression in gestational trophoblastic diseases. Int J Gynecol Cancer. 2010;20(3):337–340.
38.
BurnettTGTashJSHuntJS. Investigation of the role of nitric oxide synthase 2 in pregnancy using mutant mice. Reproduction. 2002;124(1):49–57.
39.
RidnourLAThomasDDMancardiDThe chemistry of nitrosative stress induced by nitric oxide and reactive nitrogen oxide species. Putting perspective on stressful biological situations. Biol Chem. 2004;385(1):1–10.
40.
ReesMDKennettECWhitelockJMDaviesMJ. Oxidative damage to extracellular matrix and its role in human pathologies. Free Radic Biol Med. 2008;44(12):1973–2001.
41.
AlexanderPGChauLTuanRS. Role of nitric oxide in chick embryonic organogenesis and dysmorphogenesis. Birth Defects Res A Clin Mol Teratol. 2007;79(8):581–594.
42.
GilboaSMMendolaPOlshanAFRelation between ambient air quality and selected birth defects, seven county study, Texas, 1997-2000. Am J Epidemiol. 2005;162(3):238–252.
43.
RitzBYuFFruinSChapaGShawGMHarrisJA. Ambient air pollution and risk of birth defects in Southern California. Am J Epidemiol. 2002;155(1):17–25.
