{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T19:39:15Z","timestamp":1781206755401,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,4,21]],"date-time":"2016-04-21T00:00:00Z","timestamp":1461196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>One infant in 700 is born with an oral cleft. Prior studies suggest low micronutrient status is associated with an increased risk of oral clefts. Environmental factors such as passive smoke exposure or supplement use may also affect oral cleft risk. We examined nutrition and environmental related risk factors for oral clefts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a case\u2013control study in Northeast Thailand in 2012 to 2013. We enrolled 95 cases and 95 controls. We recruited cases with a nonsyndromic cleft lip with or without a cleft palate (CL\u00b1P) less than 24 months old. Cases were matched to controls on age and place of conception. We collected survey data, a food frequency questionnaire, and measured zinc concentrations in toenail trimmings. We calculated descriptive statistics by case and control status. We used conditional logistic regression to estimate unadjusted and adjusted associations, 95% confidence intervals (CIs), and <jats:italic>p<\/jats:italic>\u2010values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Any liver intake (adjusted OR [aOR] for \u22651\/week versus none), 10.58; 95%CI, 1.74\u201364.37, overall <jats:italic>p<\/jats:italic> = 0.02) and the presence of food insecurity (aOR, 9.62; 95% CI, 1.52\u201361.05; <jats:italic>p<\/jats:italic> = 0.02) in the periconceptional period increased CL\u00b1P risk. Passive smoke exposure increased the risk of CL\u00b1P (aOR, 6.52; 95% CI, 1.98\u201321.44; <jats:italic>p<\/jats:italic> &lt; 0.01). Toenail zinc concentrations were not associated with CL\u00b1P risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings add to a growing body of knowledge of environmental risk factors for oral clefts from low\u2010 and middle\u2010income countries. Our findings on liver are contradictory to prior results. Large multisite studies are needed to identify environmental and genetic risk factors for oral clefts. 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