1. Maternal Alcohol Consumption and Risk of Orofacial Clefts Lixian Sun Department of Epidemiology

2. Orofacial Clefts Birth prevalence of 1-2/ 1,000 births Defect Type  Cleft lip only (CL)  Cleft palate only (CP)  Cleft lip with cleft palate (CLP)

3. Alcohol Consumption 2002 Behavioral Risk Factor Surveillance System found over 50% of women of childbearing age (18-44) reported any alcohol use in previous 30 days of their pregnancies. Among women who might become pregnant, 55% reported any drinking, 13% reported drink more than 7 drinks per week and 12.4% reported binge drinking (=> 5 at one time)

4. NBDPS Multi-center (10 centers) study headed by CDC. Identify risk factors for infants with birth defects. Over 30 major birth defects were classified

5. Hypothesis H0: Periconceptional * alcohol consumption can increase the risk of having oralfacial clefts. * periconceptional: from one month before pregnancy to the end of first trimester of the pregnancy

6. Case/Control Selection Cases were identified from live births, fetal deaths and elective terminations Controls included only live births without any major birth defect. All case and control moms completed telephone interview.

7. Alcohol Exposure  No alcohol consumption (reference group)  Any alcohol consumption

8. Sample Size Cases and Controls using in this project were born from Jan 1 to Dec 31, year 2005 Cases: 286 Controls: 789

9. Methods Both non-informative priors and informative priors were used GLM with logit link function was used to estimate the odds ratio Convergence was checked Potential confounders (Baby’s gender and Maternal cigarette smoking from B1 to P3) were adjusted

10. Using Non-informative Priors Alpha ~ dnorm (0, 0.01) Betas ~ dnorm (10,0.01)

11. Running 1000 iterations Auto correlation

12. History plots

13. BGR Diagnostic

14. Re-run 19000 more iterations and burn in 10000

15. Summary of Statistics node mean sd2.5%97.5% OR0.86310.12930.8541.139

16. Using Informative Priors beta1~dnorm(0.0431, 1312) beta2~dnorm(0.3135, 349) beta3~dnorm(0.3593, 249) alpha ~dnorm(-1.298, 528)

17. Run 1000 iterations Auto correlation

18. History plot

19. BGR diagnostics

20. Re-run 3000 iterations and burn in 1000 iterations Summary of Statistics node mean sd2.5%97.5% OR1.0380.02820.9837 1.096

21. Summary No evidence to show that alcohol is an effect factor of oral facial cleft. Using informative priors provides narrower credible set Less iterations were needed if informative prior was used.

22. More analyses Examine the effect of alcohol consumption and different phenotype of oralfacial clefts. Examine the effect of alcohol by alcohol type. Examine the effect of alcohol by exposure of binge drinking.

23. Acknowledgements All participated families Professor Cowles Every one in this class My daughter for her coming back