Journal of Multidisciplinary Applied Natural Science
Open Access Journal
Scopus CiteScore 2024
4.8
Calculated on 05 May, 2025
SJR 2024
0.31
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Open Access Journal
4.8
Calculated on 05 May, 2025
0.31
Powered by scimagojr.com
https://doi.org/10.47352/jmans.2774-3047.232
Katharina Oginawati
Intan Nur’azizah Rahman
Nurul Fahimah
Rinaldy Jose Nathanael
Imtiyaz Olaf Jatmy
Taqya Izdihar Muhanandi
Ida Latifah
Andi Tajrin
Ikeu Tanziha
Shinta Silvia
Farah Asnely Putri
Ida Ayu Astuti
Asri Arumsari
Utriweni Mukhaiyar
Cleft lip and palate (CLP) are multifactorial birth defects, and the etiology behind their occurrence remains insufficiently understood. This case-control study aimed to investigate the association between residential environmental factors, parental lifestyle, and the risk of CLP in Indonesia. A total of 213 participants from 14 provinces were selected using stratified random sampling. Multivariable logistic regression was employed to determine the odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor. The study identified significant associations between several residential environmental factors and CLP. Proper kitchen ventilation was found to be protective (OR = 0.245, 95% CI: 0.096–0.624, p = 0.003), while proximity to industrial sites significantly increased the risk (OR = 3.595, 95% CI: 1.029–12.558, p = 0.045). Additionally, using treated drinking water showed a protective effect (OR = 0.39, 95% CI: 0.16–0.95, p = 0.038), whereas concerns about water sources displayed a marginally significant risk increase (OR = 2.841, 95% CI: 0.876–9.211, p = 0.082). Regarding parental lifestyle factors, maternal active smoking exhibited a marginal protective association (OR = 0.052, 95% CI: 0.002–1.09, p = 0.057), while paternal passive smoking presented a marginally significant risk (OR = 2.309, 95% CI: 0.897–5.942, p = 0.083). Furthermore, paternal radiation exposure was associated with an elevated risk of CLP (OR = 3.489, 95% CI: 0.828–14.703, p = 0.089). These findings highlight the need for targeted public health interventions to mitigate environmental exposures and promote safer parental lifestyle behaviors in Indonesia.
[1] T. Vyas, P. Gupta, S. Kumar, R. Gupta, T. Gupta, and H. P. Singh. (2020). "Cleft of lip and palate: A review". Journal of Family Medicine and Primary Care. 9 (6): 2621-2625. 10.4103/jfmpc.jfmpc_472_20.
DOI: https://doi.org/10.4103/jfmpc.jfmpc_472_20[2] P. A. Nelson, S. A. Kirk, A. L. Caress, and A. M. Glenny. (2012). "Parents' emotional and social experiences of caring for a child through cleft treatment". Qualitative Health Research. 22 (3): 346-59. 10.1177/1049732311421178.
DOI: https://doi.org/10.1177/1049732311421178[3] P. A. Mossey, J. Little, R. G. Munger, M. J. Dixon, and W. C. Shaw. (2009). "Cleft lip and palate". Lancet. 374 (9703): 1773-85. 10.1016/S0140-6736(09)60695-4.
DOI: https://doi.org/10.1016/S0140-6736(09)60695-4[4] M. J. Dixon, M. L. Marazita, T. H. Beaty, and J. C. Murray. (2011). "Cleft lip and palate: understanding genetic and environmental influences". Nature Reviews Genetics. 12 (3): 167-78. 10.1038/nrg2933.
DOI: https://doi.org/10.1038/nrg2933[5] N. Salari, N. Darvishi, M. Heydari, S. Bokaee, F. Darvishi, and M. Mohammadi. (2022). "Global prevalence of cleft palate, cleft lip and cleft palate and lip: A comprehensive systematic review and meta-analysis". Journal of Stomatology, Oral and Maxillofacial Surgery. 123 (2): 110-120. 10.1016/j.jormas.2021.05.008.
DOI: https://doi.org/10.1016/j.jormas.2021.05.008[6] A. Sundoro, D. Hilmanto, H. Soedjana, R. Lesmana, and S. Harianti. (2024). "Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review". Archives of Craniofacial Surgery. 25 (2): 62-70. 10.7181/acfs.2023.00416.
DOI: https://doi.org/10.7181/acfs.2023.00416[7] M. L. N. Sanchez, R. H. Benjamin, L. E. Mitchell, P. H. Langlois, M. A. Canfield, M. D. Swartz, A. E. Scheuerle, D. A. Scott, H. Northrup, C. P. Schaaf, J. W. Ray, S. D. McLean, H. Chen, P. J. Lupo, and A. J. Agopian. (2022). "Birth Defect Co-Occurrence Patterns Among Infants With Cleft Lip and/or Palate". The Cleft Palate Craniofacial Journal. 59 (4): 417-426. 10.1177/10556656211010060.
DOI: https://doi.org/10.1177/10556656211010060[8] F. M. Gasca-Sanchez, J. Santos-Guzman, R. Elizondo-Duenaz, G. M. Mejia-Velazquez, C. Ruiz-Pacheco, D. Reyes-Rodriguez, E. Vazquez-Camacho, J. A. Hernandez-Hernandez, R. D. C. Lopez-Sanchez, R. Ortiz-Lopez, D. Olvera-Posada, and A. Rojas-Martinez. (2019). "Spatial Clusters of Children with Cleft Lip and Palate and Their Association with Polluted Zones in the Monterrey Metropolitan Area". International Journal of Environmental Research and Public Health. 16 (14). 10.3390/ijerph16142488.
DOI: https://doi.org/10.3390/ijerph16142488[9] H. R. Muntz and J. D. Meier. (2013). "The financial impact of unrepaired cleft lip and palate in the Philippines". International Journal of Pediatric Otorhinolaryngology. 77 (12): 1925-8. 10.1016/j.ijporl.2013.08.023.
DOI: https://doi.org/10.1016/j.ijporl.2013.08.023[10] J. Suhl, P. A. Romitti, C. Rocheleau, Y. Cao, T. L. Burns, K. Conway, E. M. Bell, P. Stewart, P. Langlois, and S. National Birth Defects Prevention. (2018). "Parental occupational pesticide exposure and nonsyndromic orofacial clefts". Journal of Occupational and Environmental Hygiene. 15 (9): 641-653. 10.1080/15459624.2018.1484127.
DOI: https://doi.org/10.1080/15459624.2018.1484127[11] N. Spinder, J. E. H. Bergman, H. M. Boezen, R. C. H. Vermeulen, H. Kromhout, and H. E. K. de Walle. (2017). "Maternal occupational exposure and oral clefts in offspring". Environmental Health. 16 (1): 83. 10.1186/s12940-017-0294-5.
DOI: https://doi.org/10.1186/s12940-017-0294-5[12] R. H. Nguyen, A. J. Wilcox, B. E. Moen, D. R. McConnaughey, and R. T. Lie. (2007). "Parent's occupation and isolated orofacial clefts in Norway: a population-based case-control study". Annals of Epidemiology. 17 (10): 763-71. 10.1016/j.annepidem.2007.04.008.
DOI: https://doi.org/10.1016/j.annepidem.2007.04.008[13] R. S. de Andrade, F. E. S. Oliveira, D. R. B. Martelli, L. M. de Barros, and H. Martelli Junior. (2023). "Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts". Clinics (Sao Paulo). 78 : 100266. 10.1016/j.clinsp.2023.100266.
DOI: https://doi.org/10.1016/j.clinsp.2023.100266[14] S. A. Collier, M. L. Browne, S. A. Rasmussen, M. A. Honein, and S. National Birth Defects Prevention. (2009). "Maternal caffeine intake during pregnancy and orofacial clefts". Birth Defects Research Part A: Clinical and Molecular Teratology. 85 (10): 842-9. 10.1002/bdra.20600.
DOI: https://doi.org/10.1002/bdra.20600[15] A. R. Vieira. (2012). "Genetic and environmental factors in human cleft lip and palate". Frontiers of Oral Biology. 16 : 19-31. 10.1159/000337521.
DOI: https://doi.org/10.1159/000337521[16] E. M. Moore, R. Migliorini, M. A. Infante, and E. P. Riley. (2014). "Fetal Alcohol Spectrum Disorders: Recent Neuroimaging Findings". Current Developmental Disorders Reports. 1 (3): 161-172. 10.1007/s40474-014-0020-8.
DOI: https://doi.org/10.1007/s40474-014-0020-8[17] T. Dey, A. Mukherjee, and S. Chakraborty. (2020). "A Practical Overview of Case-Control Studies in Clinical Practice". Chest. 158 (1S): S57-S64. 10.1016/j.chest.2020.03.009.
DOI: https://doi.org/10.1016/j.chest.2020.03.009[18] M. S. Bloom. (2019). In: "Encyclopedia of Environmental Health". 419-427. 10.1016/b978-0-12-409548-9.10635-9.
DOI: https://doi.org/10.1016/B978-0-12-409548-9.10635-9[19] D. A. Seli and H. S. Taylor. (2023). "The impact of air pollution and endocrine disruptors on reproduction and assisted reproduction". Current Opinion in Obstetrics and Gynecology. 35 (3): 210-215. 10.1097/GCO.0000000000000868.
DOI: https://doi.org/10.1097/GCO.0000000000000868[20] M. M. Veras, E. G. Caldini, M. Dolhnikoff, and P. H. Saldiva. (2010). "Air pollution and effects on reproductive-system functions globally with particular emphasis on the Brazilian population". Journal of Toxicology and Environmental Health. 13 (1): 1-15. 10.1080/10937401003673800.
DOI: https://doi.org/10.1080/10937401003673800[21] P. Rani and A. Dhok. (2023). "Effects of Pollution on Pregnancy and Infants". Cureus. 15 (1): e33906. 10.7759/cureus.33906.
DOI: https://doi.org/10.7759/cureus.33906[22] L. Li, N. Zhang, X. Wu, T. Feng, Z. Zhao, Y. Pang, Y. Zhang, N. Wang, J. Ning, S. Zhao, T. Jiang, B. Shi, Y. Niu, R. Zhang, and G. Hao. (2022). "Exposure to air pollution is associated with congenital anomalies in the population born by in vitro fertilization". Environmental Research. 207 : 112161. 10.1016/j.envres.2021.112161.
DOI: https://doi.org/10.1016/j.envres.2021.112161[23] K. Ravindra, N. Chanana, and S. Mor. (2021). "Exposure to air pollutants and risk of congenital anomalies: A systematic review and metaanalysis". Science of The Total Environment. 765 : 142772. 10.1016/j.scitotenv.2020.142772.
DOI: https://doi.org/10.1016/j.scitotenv.2020.142772[24] D. Q. Tong, T. E. Gill, W. A. Sprigg, R. S. Van Pelt, A. A. Baklanov, B. M. Barker, J. E. Bell, J. Castillo, S. Gassó, C. J. Gaston, D. W. Griffin, N. Huneeus, R. A. Kahn, A. P. Kuciauskas, L. A. Ladino, J. Li, O. L. Mayol‐Bracero, O. Z. McCotter, P. A. Méndez‐Lázaro, P. Mudu, S. Nickovic, D. Oyarzun, J. Prospero, G. B. Raga, A. U. Raysoni, L. Ren, N. Sarafoglou, A. Sealy, Z. Sun, and A. V. Vimic. (2023). "Health and Safety Effects of Airborne Soil Dust in the Americas and Beyond". Reviews of Geophysics. 61 (2). 10.1029/2021rg000763.
DOI: https://doi.org/10.1029/2021RG000763[25] Y. L. Wang, M. M. Tsou, K. H. Pan, H. Ozkaynak, W. Dang, H. C. Hsi, and L. C. Chien. (2021). "Estimation of Soil and Dust Ingestion Rates from the Stochastic Human Exposure and Dose Simulation Soil and Dust Model for Children in Taiwan". Environmental Science & Technology Journal. 55 (17): 11805-11813. 10.1021/acs.est.1c00706.
DOI: https://doi.org/10.1021/acs.est.1c00706[26] M. Kottek and M. L. Yuen. (2022). "Public health risks from asbestos cement roofing". American Journal of Industrial Medicine. 65 (3): 157-161. 10.1002/ajim.23321.
DOI: https://doi.org/10.1002/ajim.23321[27] A. Pallegedara and A. S. Kumara. (2022). "Impacts of firewood burning for cooking on respiratory health and healthcare utilisation: Empirical evidence from Sri Lankan micro-data". The International Journal of Health Planning and Management. 37 (1): 465-485. 10.1002/hpm.3350.
DOI: https://doi.org/10.1002/hpm.3350[28] Suman, E. D. Thera, and N. Kumar. (2024). In: "Health Effects of Indoor Air Pollution". 223-231. 10.1016/b978-0-443-16090-5.00007-6.
DOI: https://doi.org/10.1016/B978-0-443-16090-5.00007-6[29] J. D. Brender, J. A. Maantay, and J. Chakraborty. (2011). "Residential proximity to environmental hazards and adverse health outcomes". American Journal of Public Health. 101 Suppl 1 (Suppl 1): S37-52. 10.2105/AJPH.2011.300183.
DOI: https://doi.org/10.2105/AJPH.2011.300183[30] F. Hassanein, I. M. Masoud, M. M. Fekry, M. S. Abdel-Latif, H. Abdel-Salam, M. Salem, and A. I. Shehata. (2023). "Environmental health aspects and microbial infections of the recreational water : Microbial Infections and Swimming pools". BMC Public Health. 23 (1): 302. 10.1186/s12889-023-15183-z.
DOI: https://doi.org/10.1186/s12889-023-15183-z[31] E. V. Blanco, A. O. d. l. Torre, P. Bolaños-Ríos, I. Ruiz-Prieto, A. Velasco, and I. Jáuregui-Lobera. (2015). "City Vs. Countryside: Where Do You Eat Best And Healthiest?". Nutricion Hospitalaria. 32 : 2286-93. 10.3305/nh.2015.32.5.9688.
[32] S. Kosaka, K. Suda, B. Gunawan, A. Raksanagara, C. Watanabe, and M. Umezaki. (2018). "Urban-rural difference in the determinants of dietary and energy intake patterns: A case study in West Java, Indonesia". PLoS One. 13 (5): e0197626. 10.1371/journal.pone.0197626.
DOI: https://doi.org/10.1371/journal.pone.0197626[33] U. Kini. (2023). "Genetics and orofacial clefts: a clinical perspective". British Dental Journal. 234 (12): 947-952. 10.1038/s41415-023-5994-3.
DOI: https://doi.org/10.1038/s41415-023-5994-3[34] L. T. Stayner, A. S. Jensen, J. Schullehner, V. R. Coffman, B. B. Trabjerg, J. Olsen, B. Hansen, M. Pedersen, C. B. Pedersen, and T. Sigsgaard. (2022). "Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark". The Lancet Regional Health - Europe. 14 : 100286. 10.1016/j.lanepe.2021.100286.
DOI: https://doi.org/10.1016/j.lanepe.2021.100286[35] I. Delpla, C. Legay, F. Proulx, and M. J. Rodriguez. (2020). "Perception of tap water quality: Assessment of the factors modifying the links between satisfaction and water consumption behavior". Science of The Total Environment. 722 : 137786. 10.1016/j.scitotenv.2020.137786.
DOI: https://doi.org/10.1016/j.scitotenv.2020.137786[36] E. Ojomo, M. Elliott, L. Goodyear, M. Forson, and J. Bartram. (2015). "Sustainability and scale-up of household water treatment and safe storage practices: Enablers and barriers to effective implementation". International Journal of Hygiene and Environmental Health. 218 (8): 704-13. 10.1016/j.ijheh.2015.03.002.
DOI: https://doi.org/10.1016/j.ijheh.2015.03.002[37] S. Reeves and I. Bernstein. (2008). "Effects of maternal tobacco-smoke exposure on fetal growth and neonatal size". Expert Review of Obstetrics & Gynecology. 3 (6): 719-730. 10.1586/17474108.3.6.719.
DOI: https://doi.org/10.1586/17474108.3.6.719[38] A. Hackshaw, C. Rodeck, and S. Boniface. (2011). "Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls". Human Reproduction Update. 17 (5): 589-604. 10.1093/humupd/dmr022.
DOI: https://doi.org/10.1093/humupd/dmr022[39] J. B. Dai, Z. X. Wang, and Z. D. Qiao. (2015). "The hazardous effects of tobacco smoking on male fertility". Asian Journal of Andrology. 17 (6): 954-60. 10.4103/1008-682X.150847.
DOI: https://doi.org/10.4103/1008-682X.150847[40] C. Ladeira, G. Gajski, M. Meneses, M. Geric, and S. Viegas. (2020). "The genotoxicity of an organic solvent mixture: A human biomonitoring study and translation of a real-scenario exposure to in vitro". Regulatory Toxicology and Pharmacology. 116 : 104726. 10.1016/j.yrtph.2020.104726.
DOI: https://doi.org/10.1016/j.yrtph.2020.104726[41] N. Verma, S. Pandit, P. K. Gupta, S. Kumar, A. Kumar, S. K. Giri, G. Yadav, and K. Priya. (2022). "Occupational health hazards and wide spectrum of genetic damage by the organic solvent fumes at the workplace: A critical appraisal". Environmental Science and Pollution Research. 29 (21): 30954-30966. 10.1007/s11356-022-18889-6.
DOI: https://doi.org/10.1007/s11356-022-18889-6[42] C. Chevrier, B. Dananche, M. Bahuau, A. Nelva, C. Herman, C. Francannet, E. Robert-Gnansia, and S. Cordier. (2006). "Occupational exposure to organic solvent mixtures during pregnancy and the risk of non-syndromic oral clefts". Journal of Occupational and Environmental Medicine. 63 (9): 617-23. 10.1136/oem.2005.024067.
DOI: https://doi.org/10.1136/oem.2005.024067[43] Y. J. Kim, J. W. Lee, Y. H. Cho, Y. J. Choi, Y. Lee, and H. W. Chung. (2022). "Chromosome Damage in Relation to Recent Radiation Exposure and Radiation Quality in Nuclear Power Plant Workers". Toxics. 10 (2). 10.3390/toxics10020094.
DOI: https://doi.org/10.3390/toxics10020094[44] R. Kumar and O. De Jesus.(2024)." Radiation Effects On The Fetus.
[45] A. T. Alahmar, R. Singh, and A. Palani. (2022). "Sperm DNA Fragmentation in Reproductive Medicine: A Review". Journal of Human Reproductive Sciences. 15 (3): 206-218. 10.4103/jhrs.jhrs_82_22.
DOI: https://doi.org/10.4103/jhrs.jhrs_82_22[46] Y. Koohestanidehaghi, M. A. Khalili, F. Dehghanpour, and M. Seify. (2024). "Detrimental impact of cell phone radiation on sperm DNA integrity". Clinical and Experimental Reproductive Medicine. 51 (1): 13-19. 10.5653/cerm.2023.06121.
DOI: https://doi.org/10.5653/cerm.2023.06121[47] P. Sachdeva, B. G. Patel, and B. K. Patel. (2009). "Drug use in pregnancy; a point to ponder!". Indian Journal of Pharmaceutical Sciences. 71 (1): 1-7. 10.4103/0250-474X.51941.
DOI: https://doi.org/10.4103/0250-474X.51941[48] W. Zou, S. Xie, C. Liang, D. Xie, J. Fang, B. Ouyang, L. Sun, and H. Wang. (2022). "Medication use during pregnancy and birth defects in Hunan province, China, during 2016-2019: A cross-sectional study". Medicine (Baltimore). 101 (40): e30907. 10.1097/MD.0000000000030907.
DOI: https://doi.org/10.1097/MD.0000000000030907[49] V. Tomic, G. Sporis, J. Tomic, Z. Milanovic, D. Zigmundovac-Klaic, and S. Pantelic. (2013). "The effect of maternal exercise during pregnancy on abnormal fetal growth". Croatian Medical Journal. 54 (4): 362-8. 10.3325/cmj.2013.54.362.
DOI: https://doi.org/10.3325/cmj.2013.54.362[50] G. P. Mena, G. I. Mielke, and W. J. Brown. (2019). "The effect of physical activity on reproductive health outcomes in young women: a systematic review and meta-analysis". Human Reproduction Update. 25 (5): 541-563. 10.1093/humupd/dmz013.
DOI: https://doi.org/10.1093/humupd/dmz013