{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:16:39Z","timestamp":1785410199990,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T00:00:00Z","timestamp":1368748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Clubfoot is a common structural malformation, occurring in approximately 1\/1,000 live births. Previous studies of sociodemographic and pregnancy\u2010related risk factors have been inconsistent, with the exception of the strong male preponderance and association with primiparity. Hypotheses for clubfoot pathogenesis include fetal constraint, Mendelian\u2010inheritance, and vascular disruption, but its etiology remains elusive. We conducted a population\u2010based case\u2013control study of clubfoot in North Carolina, Massachusetts, and New York from 2007 to 2011. Mothers of 677 clubfoot cases and 2,037 non\u2010malformed controls were interviewed within 1 year of delivery about socio\u2010demographic and reproductive factors. Cases and controls were compared for child's sex, maternal age, education, cohabitation status, race\/ethnicity, state, gravidity, parity, body mass index (BMI), and these pregnancy\u2010related conditions: oligohydramnios, breech delivery, bicornuate uterus, plural birth, early amniocentesis (&lt;16 weeks), chorionic villous sampling (CVS), and plural gestation with fetal loss. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for state. Cases were more likely to be male (OR: 2.7; 2.2\u20133.3) and born to primiparous mothers (1.4; 1.2\u20131.7) and mothers with BMI \u226530\u2009kg\/m<jats:sup>2<\/jats:sup>(1.4; 1.1\u20131.8). These associations were greatest in isolated and bilateral cases. ORs for the pregnancy\u2010related conditions ranged from 1.3 (breech delivery) to 5.6 (early amniocentesis). Positive associations with high BMI were confined to cases with a marker of fetal constraint (oligohydramnios, breech delivery, bicornuate uterus, plural birth), inheritance (family history in 1st degree relative), or vascular disruption (early amniocentesis, CVS, plural gestation with fetal loss). Pathogenetic factors associated with obesity may be in the causal pathway for clubfoot. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajmg.a.35955","type":"journal-article","created":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T19:43:39Z","timestamp":1368819819000},"page":"1569-1578","source":"Crossref","is-referenced-by-count":79,"title":["Descriptive epidemiology of idiopathic clubfoot"],"prefix":"10.1002","volume":"161","author":[{"given":"Martha M.","family":"Werler","sequence":"first","affiliation":[{"name":"Slone Epidemiology Center at Boston University Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa M.","family":"Yazdy","sequence":"additional","affiliation":[{"name":"Slone Epidemiology Center at Boston University Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen A.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Slone Epidemiology Center at Boston University Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Meyer","sequence":"additional","affiliation":[{"name":"North Carolina Birth Defects Monitoring Program State Center for Health Statistics Raleigh, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte M.","family":"Druschel","sequence":"additional","affiliation":[{"name":"Congenital Malformations Registry New York State Department of Health Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Anderka","sequence":"additional","affiliation":[{"name":"Massachusetts Birth Defects Monitoring Program Massachusetts Department of Public Health Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Kasser","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Department of Orthopaedic Surgery Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan T.","family":"Mahan","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Department of Orthopaedic Surgery Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199107000-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2010.25"},{"key":"e_1_2_6_4_1","first-page":"864","article-title":"Clubfeet associated with hydrocephalus: New evidence of gradual dynamic development in utero","volume":"79","author":"Bronshtein M","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2005.00647.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-62"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2005.00648.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.21.4.290"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2007.12.010"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0384-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20417"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2012.05.024"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/152.7.658"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33481"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30514"},{"key":"e_1_2_6_16_1","unstructured":"MDPH.2010.Massachusetts Births 2008 Massachusetts Department of Public Health."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30505"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35250"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00360-010-0483-9"},{"key":"e_1_2_6_20_1","unstructured":"NCDHHS.2010.Risk factors for 2008 NC resident live births North Carolina Department of Health and Human Services."},{"key":"e_1_2_6_21_1","unstructured":"NYSDOH.2010.Live Births by Race\/Ethnicity and Resident County New York State 2008 NY Department of Health."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806253382604"},{"key":"e_1_2_6_23_1","unstructured":"PASW.2009.PASW Statistics 18. 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