SynthesisPloS one2015
Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Circulating fibroblast growth factor 21 levels in gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Maternal factors increase risk of orofacial cleft: a meta-analysis.Scientific reports · 2024Pooled it
- Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2022Pooled it
- The effect of prepregnancy body mass index on maternal micronutrient status: a meta-analysis.Scientific reports · 2021Pooled it
- A systematic review and meta-analysis of the serum lipid profile in prediction of diabetic neuropathy.Scientific reports · 2021Pooled it
- A systematic review and meta-analysis of community and primary-care-based hepatitis C testing and treatment services that employ direct acting antiviral drug treatments.BMC health services research · 2019Pooled it
- Cleft Lip with or without palate in seven countries with two income levels: a cross-sectional study.BMC oral health · 2026Article
- Prenatal Cannabis and Tobacco: Studies in Animal Models.Advances in experimental medicine and biology · 2026Review
- Expanding the Genetic Spectrum of Non-Syndromic Cleft Lip and Palate Through Whole-Exome Sequencing.International journal of molecular sciences · 2025Article
- Etiology of Cleft Lip and/or Cleft Palate in Southeastern Poland Based on Current Observational Study.Journal of clinical medicine · 2025Article
- Maternal and Parent-of-Origin Gene-Environment Effects on the Etiology of Orofacial Clefting.Genes · 2025Article
- Autoimmune Thyroid Disease and Pregnancy: The Interaction Between Genetics, Epigenetics and Environmental Factors.Journal of clinical medicine · 2024Review
- Cleft lip and palate and periconception COVID-19 infection in five arab countries.Clinical oral investigations · 2024Article
- COVID-19 vaccine and non-syndromic orofacial clefts in five arab countries. A case-control study.Clinical oral investigations · 2024Article
- An intercontinental comparison of the influence of smoking on the occurrence of nonsyndromic cleft lip and palate: a meta-analysis and systematic review.Archives of craniofacial surgery · 2024Article
- Assessment of non-syndromic orofacial cleft severity and associated environmental factors in Saudi Arabia: A cross-sectional study.The Saudi dental journal · 2024Article
- Association between exposure to environmental pollutants and increased oral health risks, a comprehensive review.Frontiers in public health · 2024Review
- Review
- Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate.Journal of clinical medicine · 2023Review
- The Impact of Prenatal Environmental Tobacco Smoking (ETS) and Exposure on Chinese Children: A Systematic Review.Children (Basel, Switzerland) · 2023Review
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundStudies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC). However, no comprehensive assessment of the association between NSOFC and passive smoking has been undertaken. This systematic review and meta-analysis explores the relationship between maternal passive smoking and NSOFC, and compares the associations between passive and active smoking. METHODS AND
findingsSearch strategy, inclusion / exclusion criteria, and data extraction from studies reporting maternal passive smoking and NSOFC was implemented without language restrictions. Risks of bias in the identified studies were assessed and this information was used in sensitivity analyses to explain heterogeneity. Meta-analysis and meta-regression of the extracted data were performed. Egger's test was used to test for small study effects. Fourteen eligible articles were identified. Maternal passive smoking exposure was associated with a twofold increase in risk of NSOFC (odds ratio: 2.11, 95% confidence interval: 1.54-2.89); this was apparent for both cleft lip with and without palate (OR: 2.05, 95% CI: 1.27-3.3) and cleft palate (OR: 2.11, 95% CI: 1.23-3.62). There was substantial heterogeneity between studies. In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk.
conclusionOverall, maternal passive smoking exposure results in a 1.5 fold increase in risk of NSOFC, similar to the magnitude of risk reported for active smoking, but there is marked heterogeneity between studies. This heterogeneity is not explained by differences in the distribution of cleft types, adjustment for covariates, broad geographic region, or study bias/quality. This thorough meta-analysis provides further evidence to minimize exposure to environmental tobacco smoke in policy making fora and in health promotion initiatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.