Oral cleft recurrence risk and subsequent maternal fertility preferences and behavior in Brazil

George L Wehby; Kwame A Nyarko; Jeffrey C Murray

doi:10.1002/bdra.23214

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Oral cleft recurrence risk and subsequent maternal fertility preferences and behavior in Brazil

Journal article

Open access

Peer reviewed

Oral cleft recurrence risk and subsequent maternal fertility preferences and behavior in Brazil

George L Wehby, Kwame A Nyarko and Jeffrey C Murray

Birth defects research. A Clinical and molecular teratology, Vol.100(1), pp.48-56

01/2014

DOI: 10.1002/bdra.23214

PMCID: PMC4103876

PMID: 24382743

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Abstract

Oral clefts are among the most common birth defects with numerous impacts on affected individuals and families. However, little is known about how being at a greater risk of having an affected child affects subsequent maternal fertility decisions. We investigated differences in fertility preferences and behavior between mothers who are themselves affected with cleft lip with/without cleft palate but have had no affected children and unaffected mothers of an affected child. We also compared these outcomes between unaffected mothers of a first versus another affected child. The sample included 1475 Brazilian women interviewed between 2004 and 2009. The outcomes were wanting more children, contraceptive use and type, and maternal age at first child. Comparisons between the various maternal groups were performed using regression analysis adjusting for conceptually relevant demographic, socioeconomic, and geographic factors. Affected mothers of unaffected children were less likely to use contraceptives than unaffected mothers of affected children by 31% (95% confidence interval, 1-53%). Among unaffected mothers, those who had a first affected child were 67% (95% confidence interval, 15-144%) more likely to use contraceptives. The results suggest that having an affected child represents a stronger signal of recurrence risk to the mother than her own cleft status, and that cleft status of the first child is especially important in influencing subsequent maternal fertility decisions in affected families. These findings highlight the importance of adequate counseling of at-risk women about recurrence risks and available care resources and policies that improve access to quality cleft care.

Cleft Lip - psychology

Genetic Predisposition to Disease

Humans

Male

Risk

Cleft Palate - genetics

Educational Status

Cleft Palate - psychology

Inheritance Patterns

Mothers - psychology

Regression Analysis

Cleft Lip - genetics

Family Planning Services

Maternal Age

Cleft Lip - pathology

Fertility

Cleft Palate - pathology

Counseling

Brazil

Adult

Female

Child

Contraception Behavior - psychology

Patient Education as Topic

Details

Title: Subtitle: Oral cleft recurrence risk and subsequent maternal fertility preferences and behavior in Brazil
Creators: George L Wehby - University of Iowa & NBER, Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa
Kwame A Nyarko
Jeffrey C Murray
Resource Type: Journal article
Publication Details: Birth defects research. A Clinical and molecular teratology, Vol.100(1), pp.48-56
DOI: 10.1002/bdra.23214
PMID: 24382743
PMCID: PMC4103876
NLM abbreviation: Birth Defects Res A Clin Mol Teratol
ISSN: 1542-0752
eISSN: 1542-0760
Publisher: Wiley; United States
Grant note: U01HD040561 / NICHD NIH HHS U01 DE020057 / NIDCR NIH HHS U01 HD040561 / NICHD NIH HHS U01 DE017958 / NIDCR NIH HHS
Language: English
Date published: 01/2014
Academic Unit: Preventive and Community Dentistry; Anatomy and Cell Biology; Health Management and Policy; Stead Family Department of Pediatrics; Epidemiology; Economics; Pediatric Dentistry; Craniofacial Anomalies Research Center; Public Policy Center (Archive); Dental Research
Record Identifier: 9984025409902771

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