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Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis

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  • Séverine Deguen
  • Wahida Kihal
  • Maxime Jeanjean
  • Cindy Padilla
  • Denis Zmirou-Navier

Abstract

Background: We conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in which pregnant women live and the risk of Congenital Heart Defects (CHDs), Neural Tube Defects (NTDs) and OroFacial Clefts (OFCs). Methods: We searched MEDLINE from its inception to December 20th, 2015 for case-control, cohort and ecological studies assessing the association between neighborhood socioeconomic level and the risk of CHDs, NTDs and the specific phenotypes Cleft Lip with or without Cleft Palate (CLP) and Cleft Palate (CP). Study-specific risk estimates were pooled according to random-effect and fixed-effect models. Results: Out of 245 references, a total of seven case-control studies, two cohort studies and two ecological studies were assessed in the systematic review; all studies were enrolled in the meta-analysis with the exception of the two cohort studies. No significant association has been revealed between CHDs or NTDs and neighborhood deprivation index. For CLP phenotype subgroups, we found a significantly higher rate in deprived neighborhoods (Odds Ratios (OR) = 1.22, 95% CI: 1.10, 1.36) whereas this was not significant for CP phenotype subgroups (OR = 1.20, 95%CI: 0.89, 1.61). Conclusion: In spite of the small number of epidemiological studies included in the present literature review, our findings suggest that neighborhood socioeconomic level where mothers live is associated only with an increased risk of CLP phenotype subgroups. This finding has methodological limitations that impede the formulation of firm conclusions, and further investigations should confirm this association.

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  • Séverine Deguen & Wahida Kihal & Maxime Jeanjean & Cindy Padilla & Denis Zmirou-Navier, 2016. "Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-25, October.
    • Handle: RePEc:plo:pone00:0159039
    DOI: 10.1371/journal.pone.0159039
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    References listed on IDEAS

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    1. Lupo, P.J. & Danysh, H.E. & Symanski, E. & Langlois, P.H. & Cai, Y. & Swartz, M.D., 2015. "Neighborhood-based socioeconomic position and risk of oral clefts among offspring," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 2518-2525.
    2. Wasserman, C.R. & Shaw, G.M. & Selvin, S. & Gould, J.B. & Syme, S.L., 1998. "Socioeconomic status, neighborhood social conditions, and neural tube defects," American Journal of Public Health, American Public Health Association, vol. 88(11), pages 1674-1680.
    3. Di Yu & Yu Feng & Lei Yang & Min Da & Changfeng Fan & Song Wang & Xuming Mo, 2014. "Maternal Socioeconomic Status and the Risk of Congenital Heart Defects in Offspring: A Meta-Analysis of 33 Studies," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-9, October.
    4. Flowerdew, Robin & Manley, David J. & Sabel, Clive E., 2008. "Neighbourhood effects on health: Does it matter where you draw the boundaries?," Social Science & Medicine, Elsevier, vol. 66(6), pages 1241-1255, March.
    5. Wehby, George L. & Murray, Jeffrey C. & Castilla, Eduardo E. & Lopez-Camelo, Jorge S. & Ohsfeldt, Robert L., 2009. "Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina," Economics & Human Biology, Elsevier, vol. 7(1), pages 84-95, March.
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    1. Filippo Temporin, 2020. "How Does Deprivation Affect Early-Age Mortality? Patterns of Socioeconomic Determinants of Neonatal and Postneonatal Mortality in Bolivia," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1681-1704, October.

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