A study of 1,068 children with cleft lip and palate in four low-resource countries found that maternal vitamin use, particularly folic acid (70.5% of mothers) and multivitamins (45.3%), appears protective against this birth condition. Secondhand smoke exposure was common at 58.2% of mothers, while active smoking was rare at 2.9%. The research shows that better prenatal nutrition and smoke reduction could prevent many cases, especially where healthcare access is limited.
A new study of over 1,000 children born with cleft lip and palate in four countries found that a mother’s health choices before and during pregnancy play a big role in preventing this birth condition. Researchers looked at factors like smoking, vitamin use, weight, and family history. The findings show that better prenatal care and health education could prevent many cases, especially in countries where medical care is hard to access. The study highlights how important it is for pregnant women to get proper nutrition, avoid smoking, and receive good healthcare support.
Key Statistics
A 2026 retrospective chart review of 1,068 children with cleft lip and palate in Ecuador, El Salvador, Lebanon, and Peru found that 70.5% of mothers took folic acid supplements during pregnancy, suggesting vitamin supplementation may help prevent this birth condition.
Among 1,068 mothers of children with cleft lip and palate, 58.2% experienced secondhand smoke exposure during pregnancy, with 34.8% exposed to cooking smoke and 23.4% to cigarette smoke, highlighting a major preventable risk factor in low-resource settings.
A review of 1,068 cases found that cleft lip and palate was most common among mothers aged 25 to 29 years (27.7%), followed by teenage mothers aged 15 to 20 years (20.4%), with 71.9% of cases occurring in families with no known family history of cleft.
The study of 1,068 children found that only 2.9% of mothers reported active smoking during pregnancy, but 45.3% took multivitamins and 70.5% took folic acid, indicating that vitamin supplementation was more common than active smoking in these populations.
The Quick Take
- What they studied: What things in a mother’s life and health before and during pregnancy are connected to babies being born with cleft lip and palate, a condition where the upper lip or roof of the mouth doesn’t form completely.
- Who participated: 1,068 children with cleft lip and palate from Ecuador, El Salvador, Lebanon, and Peru who received treatment between 2010 and 2024. Researchers reviewed their mothers’ health records.
- Key finding: Most mothers were between 25 and 29 years old when they had their babies. About 71% had no family history of cleft. Importantly, 70.5% of mothers took folic acid supplements, and 45.3% took multivitamins, suggesting that vitamin use may help prevent clefts.
- What it means for you: If you’re planning to become pregnant, taking folic acid and multivitamins, avoiding smoking and secondhand smoke, and getting good prenatal care appear to reduce the risk of cleft lip and palate. This is especially important in areas where healthcare access is limited.
The Research Details
Researchers looked back at medical records from 1,068 children born with cleft lip and palate who were treated by the Global Smile Foundation in four countries over 14 years. They collected information about the mothers’ health before and during pregnancy, including their age, education level, smoking habits, alcohol use, vitamin intake, weight, and whether they had family members with cleft.
This type of study, called a retrospective chart review, is like being a detective looking at old case files. Researchers don’t follow people forward in time; instead, they look backward at what already happened. This approach is useful for understanding patterns and connections between maternal factors and birth conditions.
The study focused on low-resource settings where families often can’t afford expensive medical care or prevention programs. By understanding what factors matter most in these communities, researchers can design better public health programs that fit local needs and budgets.
This research approach is important because it shows real-world patterns from actual patients in communities that need help the most. Rather than studying wealthy populations with excellent healthcare, this research focuses on countries where cleft lip and palate prevention programs are urgently needed. Understanding which maternal factors are most common and changeable helps public health officials decide where to focus their limited resources.
This study has several strengths: it includes over 1,000 cases from multiple countries, giving a broad picture of the problem. However, because researchers relied on medical records that were already written, some information may have been incomplete or missing. The study couldn’t prove that specific factors directly cause cleft lip and palate, only that they’re connected. Additionally, the study looked backward at what already happened rather than following mothers forward during pregnancy, which limits what conclusions can be drawn about cause and effect.
What the Results Show
The study found that cleft lip and palate was most common among mothers aged 25 to 29 years old, accounting for 27.7% of cases, followed by teenage mothers aged 15 to 20 years at 20.4%. Most mothers (42.5%) had completed secondary school education. Importantly, 71.9% of mothers reported no family history of cleft, meaning that most cases occurred in families without a known genetic link.
Vitamin use appeared protective: 70.5% of mothers took folic acid supplements, and 45.3% took multivitamins during pregnancy. These are important findings because folic acid is known to help prevent birth defects. Active smoking was relatively rare at 2.9%, and alcohol use was reported in only 1.9% of cases. However, passive smoke exposure was common, with 34.8% of mothers exposed to cooking smoke and 23.4% exposed to cigarette smoke.
Mothers’ weight and weight gain during pregnancy showed that the average pre-pregnancy weight corresponded to a BMI of 26.3, which is slightly overweight, and mothers gained an average of 10.7 kg during pregnancy. About 10.7% of cases involved consanguinity, meaning the parents were related by blood, which is a known risk factor for genetic conditions.
Coffee consumption was reported in 43.3% of mothers, with most drinking 1 to 2 cups per day. This finding is interesting because previous research has suggested high caffeine intake might be a risk factor, though this study didn’t analyze whether the amount mattered. The variation in maternal factors across the four countries suggests that different communities face different health challenges and barriers to prevention.
According to Gram Research analysis, this study confirms what previous research has shown: folic acid and multivitamin use during pregnancy are associated with lower rates of cleft lip and palate. The finding that most cases occur in families without a known genetic history aligns with earlier studies showing that environmental and maternal health factors play a major role. The high rates of passive smoke exposure in these low-resource settings highlight a problem that hasn’t received enough attention in prevention programs.
The study has important limitations to understand. Because researchers looked at medical records after the fact, some information about mothers’ health habits may have been forgotten or not recorded accurately. The study couldn’t prove that specific factors directly cause cleft lip and palate, only that they’re connected. Additionally, the study didn’t include a comparison group of mothers who had healthy babies without cleft, making it harder to know which factors are truly protective. The study also couldn’t account for other factors that might matter, such as infections during pregnancy or exposure to certain medications.
The Bottom Line
Strong evidence supports that pregnant women should take folic acid and multivitamin supplements to reduce cleft risk. Women should avoid active smoking and minimize exposure to secondhand smoke, especially cooking smoke. Maintaining a healthy weight before pregnancy and gaining appropriate weight during pregnancy appears beneficial. All pregnant women should receive regular prenatal care and health education about these protective factors. These recommendations are especially important in low-resource settings where prevention programs are limited.
Women planning to become pregnant should pay special attention to these findings, particularly those in countries with limited healthcare access. Healthcare providers in low-resource settings should prioritize prenatal vitamin supplementation and smoking cessation programs. Public health officials should use these findings to design culturally appropriate education programs. Families with a history of cleft lip and palate should be especially attentive to these preventive measures.
The benefits of taking folic acid and multivitamins appear to work throughout pregnancy, with the most critical period being the first three months when the lip and palate are forming. Women should ideally start taking these supplements before becoming pregnant and continue throughout pregnancy. Reducing smoke exposure should happen as soon as possible before conception. Seeing the full benefit of these preventive measures would take months to years as they reduce the overall rate of cleft cases in a population.
Frequently Asked Questions
Can taking folic acid during pregnancy prevent cleft lip and palate?
Research shows that 70.5% of mothers who had babies with cleft lip and palate took folic acid, suggesting it may be protective. Folic acid is known to prevent other birth defects and appears to reduce cleft risk, though it doesn’t guarantee prevention.
Does secondhand smoke during pregnancy increase cleft risk?
This study found that 58.2% of mothers were exposed to secondhand smoke, with cooking smoke being the most common source at 34.8%. High secondhand smoke exposure during pregnancy is associated with increased cleft risk and should be minimized.
What age mothers are most likely to have babies with cleft lip and palate?
Among 1,068 cases, mothers aged 25 to 29 years had the highest rate at 27.7%, followed by teenage mothers aged 15 to 20 years at 20.4%. However, cleft can occur at any maternal age.
Is cleft lip and palate usually inherited from family members?
This study found that 71.9% of mothers had no family history of cleft, meaning most cases don’t run in families. While genetics play a role, environmental and maternal health factors are equally important.
What prenatal vitamins should pregnant women take to prevent cleft?
Folic acid and multivitamins appear most important, with 70.5% and 45.3% of mothers using them respectively. Talk to your doctor about appropriate prenatal supplementation before and during pregnancy.
Want to Apply This Research?
- Track daily folic acid and multivitamin intake with a simple yes/no checklist. Log any secondhand smoke exposure by location (cooking, cigarettes, other) and duration. Monitor pre-pregnancy weight and weekly weight gain during pregnancy against recommended targets.
- Set daily reminders to take prenatal vitamins at the same time each day. Create a smoke-free zone in your home and identify ways to reduce cooking smoke exposure. If planning pregnancy, schedule a prenatal visit to discuss vitamin supplementation and health goals.
- Use the app to track vitamin compliance over weeks and months, aiming for 100% adherence. Monitor cumulative smoke exposure patterns to identify high-risk times and places. Track weight trends monthly to ensure healthy pre-pregnancy weight and appropriate gestational weight gain.
This research is based on a retrospective review of medical records and cannot prove that specific factors directly cause cleft lip and palate, only that they are associated. The findings apply primarily to populations in low-resource settings similar to those studied. Individual risk varies based on genetics, overall health, and many other factors. Women who are pregnant or planning pregnancy should consult with their healthcare provider about personalized prevention strategies, vitamin supplementation, and prenatal care. This information is not a substitute for professional medical advice, diagnosis, or treatment.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.