The relationship between orofacial clefts and material deprivation in Wales

Objective: This study investigated the relationship between material deprivation and the incidence of orofacial clefts (OFC) in South, West, and Central Wales, U.K. Design and Setting: The South, West, and Central Wales Orofacial-Cleft Register served as the primary data source for the study. Data on all children born with an orofacial cleft between 1982 and 2003 were geocoded to one of 844 geographic wards. National census data, similarly geocoded, served as the population denominator. Townsend's index of material deprivation was used to assign wards to one of seven levels of deprivation. This permitted investigation of the association of orofacial clefts with material deprivation. Results: Between 1982 and 2003, there were 831 babies born with an orofacial cleft, equating to 109 clefts per 100,000 live births. The incidence of orofacial clefts ranged from 82 per 100,000 (95% confidence interval [C.I.] 64 to 102 per 100,000) in babies born to mothers residing in the least deprived areas to 127 per 100,000 (95% C.I., 112 to 144 per 100,000) in those living in the most deprived areas, a significant linear trend being apparent (p < .001). A statistically significant risk of 1.55 (95% C.I., 1.18 to 2.04) for orofacial clefts was apparent between most and least deprived septiles of deprivation. Conclusions: This study provides further evidence of an association between material deprivation and orofacial clefts. Further work is required to elicit the degree to which potential risk factors contribute to this association and to determine how deprivation predisposes to orofacial clefts.