By Afsun Qureshi

They found that overall, any cigarette use during pregnancy raised the risk of cleft lip or palate 55 percent. Mothers-to-be who smoked half a pack of cigarettes or less a day had a 50 percent higher risk, while those who smoked more than a pack a day had a 78 percent higher risk.

When they examined the data further, they found that certain other characteristics in the mother or the baby seemed to increase the chance of cleft lip or palate. Baby boys and underweight babies born to smoking mothers had an increased incidence. So did babies born to mothers who smoked and had either diabetes, high blood pressure during pregnancy or less than a high school education.

Finally, mothers who were not African American or who were less than 27 years old were more likely to give birth to a child with a cleft palate or lip.

After correcting for all these factors, they still found that smokers were 30 percent more likely to have a child with the birth defect, and that the rate was still highest among those who smoked the most cigarettes.

The researchers also compared smoking data for mothers of the babies with cleft lips and palates, and those whose infants had other birth defects. This allowed them to correct for any under- or over-reporting of mothers' smoking habits due to guilt for smoking during pregnancy or, conversely, any vested interest in finding a cause for their baby's problem. Again, the mothers in the cleft lip and palate group were 37 percent more likely to smoke.

In all, the authors say, their study reinforces the importance of educational campaigns to dissuade women from smoking while pregnant.

Just as public health messages about the risks of drinking alcohol during pregnancy have resulted in a steady decline in fetal alcohol syndrome, they hope women will take heed of their results and others that have found smoking can harm a developing baby

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