Prevalence at Birth of Cleft Lip with or without Cleft Palate: Data from the International Perinatal Database of Typical Oral Clefts (IPDTOC)

Mastroiacovo, Pierpaolo; Maraschini, Alice; Leoncini, Emanuele; Mosscy, Peter; Bower, Carol; Castilla, Eduardo E.; Feldkamp, Marcia L.; Halliday, Jane; Little, Julian

doi:10.1597/09-217

Cited by 347 publications

(103 citation statements)

References 31 publications

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“…Worldwide, the birth prevalence is 1/700 live births [15]. Prevalence is highest in Asians (1/500), intermediate in Caucasians (1/1,000), and lowest in African populations (1/2,500) [8,15-18]. Clefts of the lip have a 2:1 male to female ratio, while clefts of the palate have a 1:2 male to female ratio [15].…”

Section: Introductionmentioning

confidence: 99%

Ten-year experience of more than 35,000 orofacial clefts in Africa

et al. 2015

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BackgroundSurgical correction of orofacial clefts greatly mitigates negative outcomes. However, access to reconstructive surgery is limited in developing countries. The present study reviews epidemiological data from a single charitable organization, Smile Train, with a database of surgical cases from 33 African countries from 2001–2011.MethodsDemographic and clinical patient data were collected from questionnaires completed by the participating surgeons. These data were recorded in Excel, analyzed using SPSS and compared with previously reported data.ResultsQuestionnaires were completed for 36,384 patients by 389 African surgeons. The distribution of clefts was: 34.44% clefts of the lip (CL), 58.87% clefts of the lip and palate (CLP), and 6.69% clefts of the palate only (CP). The male to female ratio was 1.46:1, and the unilateral: bilateral ratio 2.93:1, with left-sided predominance 1.69:1. Associated anomalies were found in 4.18% of patients. The most frequent surgeries included primary lip/nose repairs, unilateral (68.36%) and bilateral (11.84%). There was seasonal variation in the frequency of oral cleft births with the highest in January and lowest by December. The average age at surgery was 9.34 years and increased in countries with lower gross domestic products. The average hospital stay was 4.5 days. The reported complication rate was 1.92%.ConclusionsWith the exception of cleft palates, results follow trends of worldwide epidemiologic reports of 25% CL, 50% CLP, and 25% CP, 2:1 unilateral:bilateral and left:right ratios, and male predominance. Fewer than expected patients, especially females, presented with isolated cleft palates, suggesting that limitations in economic resources and cultural aesthetics of the obvious lip deformity may outweigh functional concerns and access to treatment for females. A fewer than expected associated anomalies suggests either true ethnic variation, or that more severely-affected patients are not presenting for treatment. The epidemiology of orofacial clefting in Africa has been difficult to assess due to the diversity of the continent and the considerable variation among study designs. The large sample size of the data collected provides a basis for further study of the epidemiology of orofacial clefting in Africa.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0328-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Ten-year experience of more than 35,000 orofacial clefts in Africa

et al. 2015

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“…Cleft lip and/or palate (CL/P) is a surgical condition of multifactorial etiology that disproportionately affects the poorest populations throughout the world. The prevalence of CL/P varies by region and global estimates range from 1 in 700 to 1 in 1000 live births worldwide [8,9]. While infant mortality is only modestly affected by CL/P in high-income settings, studies have demonstrated high infant mortality rates in even isolated forms of this condition in Latin America, as well as up to a seven-fold increase in risk of neonatal death in China [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Inequitable Access to Timely Cleft Palate Surgery in Low‐ and Middle‐Income Countries

et al. 2015

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There is a strong negative correlation between national income status and delayed access to primary cleft palate surgery, indicating a high degree of inequity in access to surgery, particularly in low- and lower-middle-income countries. As the importance of surgery in global health is increasingly recognized, an equity perspective must be included in the global dialog to ensure that the world's poor have fair and equitable access to essential surgical care.

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“…According to the International Perinatal Database of Typical Orofacial Clefts (IPDTOC) working group, the proportion of bilateral cases is 10.3% for cleft lip without palate (CL) and 30.2% for cleft lip with palate (CLP). Amongst unilateral cases, 36.9% of CL and 41.1% of CLP occur on the right side, suggesting that unilateral cases of CL/P occur more frequently on the left [7].…”

Section: Lateralitymentioning

confidence: 98%

8 Epidemiology of Cleft Lip and Palate

Losee¹,

Kirschner²

2016

Comprehensive Cleft Care, Volume 1

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Orofacial cleft (OFC) anomalies are amongst the most common congenital anomalies and the most common craniofacial anomalies. Despite their poorly characterized etiologies, cases of OFC are usually grouped by epidemiological studies as cleft lip, with or without cleft palate (CL/P), and cleft palate alone (CPO). Incidence of CL/P and CPO differs according to gender and ancestry and may vary widely across studies. Cases of OFC are characterized as either "syndromic" or "nonsyndromic," with further classification of nonsyndromic cases into isolated cases and cases that present with additional malformations. The genetic bases for many syndromic cases of OFC have been previously elucidated. Genetic associations have been described for nonsyndromic OFC as well. Importantly, etiology of OFC is known to involve interaction between genetic and environmental factors, including maternal nutrition and exposure to teratogenic agents. Furthermore, evidence points toward epigenetic as well as genetic factors influencing OFC etiology. Recent studies have begun to explore the association between CL/P and cancer. These studies report higher incidence of cancer among patients with CL/P and their family members as well as identification of common genetic markers mediating this increased risk, although much remains unknown about this link.

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Prevalence at Birth of Cleft Lip with or without Cleft Palate: Data from the International Perinatal Database of Typical Oral Clefts (IPDTOC)

Cited by 347 publications

References 31 publications

Ten-year experience of more than 35,000 orofacial clefts in Africa

Ten-year experience of more than 35,000 orofacial clefts in Africa

Inequitable Access to Timely Cleft Palate Surgery in Low‐ and Middle‐Income Countries

8 Epidemiology of Cleft Lip and Palate

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