Abstract
Objective: Congenital defects, including cleft lip and palate, increase the morbidity and mortality in the affected population. This study aimed to determine the prevalence of cleft lip and palate in the city of Bauru, Brazil, by evaluation of registry in the Brazilian Livebirth Certificate (DNV) and the Information System on Livebirths (SINASC), and analyzed the concordance of diagnosis compared with registries of the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC/USP), located in the same city. Material and Methods: This retrospective observational study comprised analysis of all DNVs and identification of individuals with clefts born and living in Bauru, comparing with data from HRAC/USP. The prevalence was calculated by dividing the number of children born with clefts in the study period by the total number of livebirths registered. The reporting of different types of clefts was compared by the chi-square test. Results: Overall, 50,898 DNV were evaluated, among which there were 25 reported cases of cleft lip and/or palate. In the same period, HRAC/USP registered 77 cases born in Bauru, representing 67.5% of underreporting of the occurrence of clefts. Cleft palate was the most prevalent (34.9%), followed by cleft lip and palate (31.7%) and cleft lip (30.2%), mostly affecting males (58.5%). The reporting of cleft palate (16.12%) was lower compared to cleft lip (43.75%) and cleft lip and palate (54.54%). Conclusion: The study revealed predominance of cleft palate, with significant underreporting of clefts in the public health system, especially for cleft palate as compared to cleft lip and cleft lip and palate. Keywords Cleft lip; Cleft palate; Epidemiology; Prevalence; Reporting.
Highlights
IntroductionCongenital defects account for a large number of intrauterine deaths and for infant morbidity and mortality
Depending on the severity, congenital defects account for a large number of intrauterine deaths and for infant morbidity and mortality
The reporting of cleft palate was significantly lower compared to cleft lip (x2 = 4.234, p = 0.04) and cleft lip and palate (x2 = 3.083, p = 0.079)
Summary
Congenital defects account for a large number of intrauterine deaths and for infant morbidity and mortality. It is estimated that 3 to 6% of newborns are affected by some type of congenital anomaly [1] and, according to Monlleó and Gil-da-Silva-Lopes (2006) [2], these are a frequent cause of death during the first year of life. Cleft lip and palate are the most common congenital craniofacial defects and can occur as isolated defects or associated with syndromes, caused by lack of union between the embryonic facial processes due to a multifactorial etiology. Depending on the development stage in which the etiological factors act, cleft lip and palate can cause esthetic, functional, psychological and social disorders, of variable severity depending on the extent and type of the defect, which can affect the lip and oral cavity, even causing oronasal communication, besides psychological changes in the newborn’s family, which is concerned with the future social integration. The treatment is performed by a highly specialized interprofessional team with professionals from the areas of plastic surgery, speech therapy, dentistry, nursing, psychology, social work, and others. [3]
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