{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:35:47Z","timestamp":1777523747008,"version":"3.51.4"},"reference-count":60,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"British Commission U.K.-India Educational and Research Initiative","award":["IND\/CONT\/E?12-13\/789"],"award-info":[{"award-number":["IND\/CONT\/E?12-13\/789"]}]},{"name":"U.S. National Institute of Dental and Craniofacial Research","award":["R21-DE016877"],"award-info":[{"award-number":["R21-DE016877"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objective:<\/jats:title>\n                    <jats:p>\n                      The causal role of maternal nutrition in orofacial clefts is uncertain. We tested hypotheses that low maternal vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      and low folate status are each associated with an increased risk of isolated cleft lip with or without cleft palate (CL\u00b1P) in a case\u2013control study in Tamil Nadu state, India.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Case-mothers of CL\u00b1P children (n = 47) and control-mothers of unaffected children (n = 50) were recruited an average of 1.4 years after birth of the index child and plasma vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      , methylmalonic acid (MMA), total homocysteine (tHcy), and folate were measured at that time. Logistic regression analyses estimated associations between nutrient biomarkers and case\u2013control status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Odds ratios (ORs) contrasting biomarker levels showed associations between case-mothers and low versus high plasma vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      (OR = 2.48, 95% CI, 1.02-6.01) and high versus low plasma MMA, an indicator of poor B\n                      <jats:sub>12<\/jats:sub>\n                      status (OR = 3.65 95% CI, 1.21-11.05). Case\u2013control status was not consistently associated with folate or tHcy levels. Low vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      status, when defined by a combination of both plasma vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      and MMA levels, had an even stronger association with case-mothers (OR = 6.54, 95% CI, 1.33-32.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Mothers of CL\u00b1P children in southern India were 6.5 times more likely to have poor vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      status, defined by multiple biomarkers, compared to control-mothers. Further studies in populations with diverse nutritional backgrounds are required to determine whether poor maternal vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      or folate levels or their interactions are causally related to CL\u00b1P.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665621998394","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T05:05:15Z","timestamp":1615266315000},"page":"567-576","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Maternal Vitamin B\n                    <sub>12<\/sub>\n                    Status and Risk of Cleft Lip and Cleft Palate Birth Defects in Tamil Nadu State, India"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2381-5355","authenticated-orcid":false,"given":"Ronald G.","family":"Munger","sequence":"first","affiliation":[{"name":"Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, the United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajarajeswari","family":"Kuppuswamy","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyotsna","family":"Murthy","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalpana","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, 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Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per M.","family":"Ueland","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen, Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Mossey","sequence":"additional","affiliation":[{"name":"School Dentistry, University of Dundee, Dundee, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"bibr1-1055665621998394","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.206599"},{"issue":"6","key":"bibr2-1055665621998394","doi-asserted-by":"crossref","first-page":"e008090","DOI":"10.1136\/bmjopen-2015-008090","volume":"5","author":"Balakrishnan K","year":"2015","journal-title":"BMJ 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