{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:18:56Z","timestamp":1787822336115,"version":"build-2784847793"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004410","name":"T\u00fcrkiye Bilimsel ve Teknolojik Ara\u015ft\u0131rma Kurumu","doi-asserted-by":"publisher","award":["123S720"],"award-info":[{"award-number":["123S720"]}],"id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cleft lip and\/or palate (CLP) is among the most common congenital anomalies worldwide. Ambient air pollution has emerged as an important environmental exposure potentially contributing to its multifactorial etiology. This study investigated associations between ambient air pollutant exposures during the preconception period and first trimester of pregnancy and the risk of CLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This hospital\u2010based case\u2013control study included 127 infants with CLP and 271 controls. Baseline participant characteristics were collected through structured interviews. Ambient air pollutant data (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\u2081\u2080, O\u2083, NO\n                      <jats:sub>2<\/jats:sub>\n                      , NO\n                      <jats:sub>x<\/jats:sub>\n                      , NO, SO\n                      <jats:sub>2<\/jats:sub>\n                      , and CO) were obtained for the 3\u2009months before conception and the first trimester of pregnancy. Associations between pollutant exposures and CLP risk were evaluated using adjusted single\u2010pollutant, multi\u2010pollutant, and weighted quantile sum (WQS) regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher exposures to ozone (O\u2083), PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , and PM\u2081\u2080 were associated with an increased CLP risk. O\u2083 demonstrated the strongest and most consistent associations across exposure windows and analytical approaches, remaining the dominant contributor in WQS mixture analyses. In contrast, associations involving traffic\u2010related pollutants were less consistent and were not retained across modeling approaches. Ambient air pollution, particularly ozone and particulate matter, was consistently associated with an increased risk of nonsyndromic CLP during the preconception period and early pregnancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings support the potential importance of air quality within the multifactorial etiology of CLP and highlight the need for further studies using refined exposure assessment, larger populations, and phenotype\u2010specific analyses to clarify causal pathways and inform prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70102","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:29:55Z","timestamp":1785500995000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preconception and Early Pregnancy Exposure to Ambient Air Pollution and Risk of Cleft Lip and\/or Palate: A Case\u2013Control Study Using Single\u2010Pollutant, Multi\u2010Pollutant, and Mixture\u2010Based Analyses"],"prefix":"10.1002","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1288-4605","authenticated-orcid":false,"given":"Fatih","family":"Sezer","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Pediatrics, Unit of Social Pediatrics Hacettepe University  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9061-4281","authenticated-orcid":false,"given":"S\u0131ddika Song\u00fcl","family":"Yal\u00e7\u0131n","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Pediatrics, Unit of Social Pediatrics Hacettepe University  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1742-3742","authenticated-orcid":false,"given":"Murat","family":"Kara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery Hacettepe University  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4922-6348","authenticated-orcid":false,"given":"Fatma Figen","family":"\u00d6zg\u00fcr","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery Hacettepe University  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aog.0000425668.87506.4c"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2005"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.05.017"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010019\u201011654\u20103"},{"key":"e_1_2_13_6_1","first-page":"59","volume-title":"K\u00fcresel \u0130klim De\u011fi\u015fikli\u011finin \u00c7ok Disiplinli G\u00f6zden Ge\u00e7irilmesi ve \u00c7ocukluktan Eri\u015fkinli\u011fe Etkileri [A Multi\u2010Disciplinary Analysis of Global Climate Change and its Effects From Childhood to Adult]","author":"\u00c7aylan N.","year":"2022"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apr.2025.102675"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102431\u201013\u201059"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16142488"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010023\u201006104\u20104"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.11311"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010021\u201001876\u20107"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2023.11.012"},{"key":"e_1_2_13_14_1","first-page":"213","article-title":"Tobacco Smoking and Oral Clefts: A Meta\u2010Analysis","volume":"82","author":"Little J.","year":"2004","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2146"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed\u20102020\u2010106434"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-022-19855-y"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0960\u20100760(95)00094\u2010g"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378\u20104274(94)90038\u20108"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246989"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2008.11.007"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.5037\/jomr.2016.7102"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648\u2010200009000\u201000004"},{"key":"e_1_2_13_24_1","first-page":"2022","volume-title":"Treatise on Geochemistry","author":"Sillman S.","year":"2003"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.6362"},{"key":"e_1_2_13_26_1","first-page":"294","article-title":"A Decrease in Serum Retinol by in Vivo Exposures of Rats to Ozone","volume":"60","author":"Takahashi Y.","year":"1990","journal-title":"International Journal for Vitamin and Nutrition Research"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1002946"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdy137"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1609700"},{"key":"e_1_2_13_30_1","volume-title":"Ambient (Outdoor) Air Pollution","author":"WHO","year":"2018"},{"key":"e_1_2_13_31_1","volume-title":"Global Air Quality Guidelines: Particulate Matter (PM2. 5 and PM10), Ozone, Nitrogen Dioxide, Sulfur Dioxide and Carbon Monoxide","author":"WHO","year":"2021"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.4007"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2018.03.053"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2016.11.007"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.70102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:27:31Z","timestamp":1787819251000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.70102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/bdr2.70102"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.70102","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"assertion":[{"value":"2026-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70102"}}