Distribution of maternal risk factors for orofacial cleft in infants in Indonesia: a multicenter prospective study.

BACKGROUND: The pathogenesis of orofacial cleft (OFC) is multifactorial, involving both genetic and non-genetic factors, the latter of which play a key role in the development of these anomalies. This paper addresses the incidence of OFC in Indonesia, with a focus on identifying and examining the distribution of contributory factors, including parental medical history, pregnancy history, and environmental influences. METHODS: The study was conducted through the collection of primary data. An interdisciplinary research team from Indonesia administered a standardized questionnaire to parents who had children with OFC and who had provided informed consent. The case group comprised 133 children born with cleft lip and/or palate, and the control was 133 noncleft children born full-term. The risk factors associated with OFC anomalies were analyzed using the chi-square test and logistic regression. All statistical analyses were performed using SPSS version 25. A p-value of 0.05 or less was considered to indicate statistical significance. RESULTS: The study comprised 138 children, of whom 82 were boys (59.4%) and 56 were girls (40.6%). Among them, 45 patients (32.6%) presented with both cleft lip and cleft palate, 25 individuals (18.1%) had a cleft palate only, and 28 patients (20.3%) had a cleft lip only. OFC was found to be significantly associated with a maternal family history of congenital birth defects (p< 0.05), complications during the first trimester (p< 0.05), consumption of local fish (p< 0.05), caffeine intake (p< 0.05), prolonged medication use (p< 0.05), immunization history (p< 0.05), passive smoking (p< 0.05), and X-ray exposure during pregnancy (p< 0.05). CONCLUSION: The findings indicate close relationships between the incidence of OFC and maternal medical history, prenatal factors, and environmental influences.

Investigation of exposure to heavy metals (Hg, Pb, Cd, Co, and Cr) as the cause of congenital anomaly cases (orofacial cleft) in infants.

Orofacial cleft (OFC) is one of the most common congenital defects, with worldwide cases occurring in approximately 1:700 to 1:1000 births. This incidence is among the highest birth defects in Indonesia, and the incidence rate in Bandung Regency (14.69%) is the second-highest in West Java province. The purpose of this study was to analyze the association of heavy metal factors that accumulate in infants to the risk of OFC in Bandung Regency. The method was used by testing heavy metals Hg, Pb, Cd, Co, and Cr in infant blood. The total sample were 54 samples, where the case respondent of 32 and 22 respondents as the control group. Blood samples were analyzed using ICP-MS Agilent 7900. The correlation using statistic analyze namely chi-square analysis (bivariate) and multiple logistic regression (multivariate). The results showed that there was a significant difference in the concentration of heavy metals Hg, Pb, and Cd as well as an increase in Pb and Cd in the infant's blood which was thought to be significantly associated with the risk of OFC.

Investigation of dermal exposure to heavy metals (Cu, Zn, Ni, Al, Fe and Pb) in traditional batik industry workers.

Batik is an Indonesian cultural heritage that has been designated by UNESCO. Batik industry is one of the industries that applies the synthetic dyes, beside natural ones which have long been used in producing Batik particularly in the modern production. The purpose of this research investigated heavy metals on workers in batik industry, which focuses on dermal detection as portal of entry. Samples of dermal intake of workers were examined with cross-sectional approach, while non-worker samples of resident living surrounding the industry were used as control. Dermal intake on workers and non-workers were examined using Patch Filter. Heavy metals content of the synthetic dyes used in the batik production and those in the patch filter which was attached to worker's skin during sampling period were analyzed using X-Ray Fluorescence (XRF) method. The XRF measurement result of the synthetic dyes shows a detection of several heavy metals including Cu and Zn as the highest detected concentration, while the XRF measurement of the patch filter detects several heavy metal contents, which include Cu, Zn, Ni, Al, Fe and Pb. The highest detected heavy metal concentration found in the patch filter were Cu, Zn and Ni. Meanwhile, the highest detected heavy metal concentration of Pb was found in workers in the stamping process. The result indicates that highest Hazard Quotient (HQ) values for Cu, Zn, Mn, and Fe were found in workers of dyeing process compared to those in other processing stages.