Date of Award:


Document Type:


Degree Name:

Master of Science (MS)


Nutrition, Dietetics, and Food Sciences

Department name when degree awarded

Nutrition and Food Sciences

Committee Chair(s)

Ronald G. Munger


Ronald G. Munger


Cigarette smoke contains sufficient carbon monoxide to induce maternal and fetal hypoxia. Hypoxia is a known teratogen, and consequently maternal smoking has been the focus of many studies on adverse birth outcomes, including cleft lip and palate. Current literature of epidemiological studies on smoking and clefts suggests a modest but statistically significant increase in risk of clefting associated with maternal smoking. A biological condition that may also contribute to hypoxia is anemia. Data from the Utah Child and Family Health Study was used to assess the effects of hypoxia-inducing conditions, maternal smoking, anemia, and their interaction, on the risk of having a child with a cleft. Smoking during the first trimester and hemoglobin levels ofless than 12.0 g/dL were the defined risk exposures and logistic regression modeling was used to test the hypotheses. Smoking during the first trimester of pregnancy was associated with increased risk of clefting; however, anemia did not appear to be associated with clefting in this population, and there was also no apparent additional increase in risk for those mothers who both smoked and were anemic. Prospects for future studies include using populations that have higher rates of anemia and smoking to gain more statistical power, and using more sensitive measures of red blood cell health other than hemoglobin. From a public health perspective, evidence from this study would suggest that efforts to promote smoking cessation in women of child-bearing years is of considerable importance.