Type of alcohol linked with cleft palate risk in infant

NEW YORK (Reuters Health) - A new study suggests that the association between alcohol consumption near the time of conception and the risk of cleft lip or palate may be influenced by the type of alcohol consumed, and by whether or not a woman is taking folic acid.

But the researchers caution that the findings are "preliminary and might reflect chance associations," and should be tested in additional, large studies.

Some genes have been linked to facial clefting, but most cases of the malformation don't appear to be genetic, Dr. Paul A. Romitti of the University of Iowa in Iowa City and colleagues write in the October 1st issue of the American Journal of Epidemiology. Studies of environmental factors, such as alcohol consumption, have had mixed results.

To better understand the alcohol-facial clefting relationship, Romitti and his team evaluated mothers participating in the National Birth Defects Prevention Study, 1,749 of whom had infants with cleft lip or palate, or both. Another 4,094 mothers whose children were born without the defect served as controls.

The researchers focused on the month before the infants were conceived and the first three months of pregnancy, known as the periconceptional period.

Binge drinking, defined as having four or five or more drinks in one sitting, was linked to an increased risk of facial clefting, although the relationship was not statistically significant. The researchers also found that the type of alcohol consumed influenced the risk, with the highest likelihood of clefting associated with binge drinking of distilled spirits, followed by wine and then beer. The relationship between drinking and cleft lip or palate was greater among women who reported not taking folic acid.

Alcohol is known to block the effects of folic acid, the researchers note, and these compounds "folic acid antagonists" have been tied to a greater risk of facial clefts.

"These findings are preliminary and require replication in future, large investigations," the researchers write. "Future investigations should also consider evaluation of genetic predisposition to differences in facial development, alcohol metabolism, or folate metabolism, which might influence the risk of clefting associated with alcohol consumption."

SOURCE: American Journal of Epidemiology, October 1, 2007.