Factors associated with the presence of cleft lip and / or cleft palate in Brazilian newborns

Abstract

Objectives: to analyze the trend and the associated factors with the presence of cleft lip and/or cleft palate in Brazilian newborns, in order to verify possible associations with maternal care and newborn factors. Methods: a cross-sectional and ecological study, involving all live births in Brazil, recorded in the Information System on Live Births from 2005 to 2016. Maternal and infant information were evaluated using trend analysis and odds ratio, with a 95% confidence interval. The analyses were performed using SPSS software. Results: we analyzed 17,800 live births with presence of cleft lip and/or cleft palate. The Brazilian prevalence rate was 0.51 / 1000 live births, with South and Southeast Regions registering higher rates than the national rate. There was an association with maternal age above 35 years old, with no partner, less than seven prenatal consultations, premature birth and cesarean section. About the factors of the newborn, being male, Apgar less than seven in the 1st and 5th minutes of life, low birth weight and white color were associated. Conclusions: Brazil has an increasing tendency for cleft lip and/or cleft palate (p=0.019), reinforcing the need to strengthen health care networks, providing adequate support for newborn with cleft lip and/or cleft palate and their families.

The Panorama of Cleft Lip and Palate Live Birth in Brazil: Follow-up of a 10-Year Period and Inequalities in the Health System

“…Concerning Brazilian regions, the South Region had the highest rate of CL/P and the Northeast region the lowest. In corroboration with our study, the South and Southeast regions registered higher rates than the national rate (Shibukawa et al, 2019). The overall prevalence between 2008 and 2017 was higher in the North, Northeast, and Southeast regions and lower in the South and Midwest regions of Brazil.…”

“…In corroboration with other Brazilian and international studies (Angulo-Castro et al, 2017;Freitas et al, 2004;Hagberg et al, 1998;Mossey et al, 2009;Ravichandran et al, 2012;Shibukawa et al, 2019;Vyas et al, 2020) the male gender prevailed in Brazil from 2008 to 2017. The highest prematurity among children born with a cleft was also present in another Brazilian study (Shibukawa et al, 2019). This factor may be related to an increase in the option for Cesarean delivery in Brazil (Behague et al, 2002), which may contribute to higher rates of prematurity (Wood et al, 2017).…”

“…This study showed that the Brazilian prevalence of CL/P was 52 children per 100 000 live births from 2008 to 2017. Similar results were demonstrated by Sousa and Roncalli (2017) with a national average of 58 per 100 000 live births from 2009 to 2013, and Shibukawa et al (2019) with 51 CL/P per 100 000 births from 2005 to 2016. These results are below the global average, with the prevalence of 1 in 700 live births worldwide [Mossey and Castillia, 2003].…”

“…In the early 90s, the Brazilian Live Birth Information System (SINASC in Portuguese) and the Hospital Information System (SIH in Portuguese) were created by the Unified Health System (SUS in Portuguese) were implemented throughout the territory. These database systems improved the control of the national analysis of vital events and coverage of medical and hospital care, respectively, with the development of reliable demographic indicators of health data (Shibukawa et al, 2019; Sousa and Roncalli, 2017).…”

Perfil epidemiológico y presencia de polimorfismos IFR6 (rs2235371), TGFA (rs3771494) en individuos con labio y paladar hendido no sindrómico

“…Actualmente, la etiología de las HO sugiere y acepta un origen multifactorial complejo, su causalidad se atribuye principalmente a los factores genético y ambiental 15 , por otra parte, se han estudiado y señalado una serie de factores de riesgo asociados al desarrollo de HO de los cuales se destacan una edad de embarazo mayor a 35 años, una duración del embarazo menor a 37 semanas, la implementación de cesáreas, el bajo número de citas prenatales 36 , así como la presencia de antecedentes familiares de enfermedades que pueden influir en el desarrollo y presencia de anomalías y un sin número de afecciones 37 . En el presente estudio, la edad al momento del embarazo mayor o igual a 35 años solo tuvo relación con el 33,3% de los individuos con SHL, de igual forma la duración del embarazo menor a 37 semanas solo se presentó en el 33,3% de SHL, mientras que el no tener citas prenatales solo se presentó en el 33,3% de SHL y en el 5% de LPH, además, la cesárea estuvo indicada en el 100% de las madres de individuos con SHL y en el 45% de madres de individuos con LPH, por último, para el historial familiar fueron las enfermedades de cáncer e hipertensión las que se reportaron en el 66,7% de madres de individuos con SHL; y solo el 15%, 20% y 20% de cáncer, diabetes e hipertensión se reportaron como historial en madres e individuos con LPH, respectivamente.…”