Incidence Of Cleft Lip Research Articles

Epidemiology of cleft lip and palate in Bhutan, 2015-2022.

The epidemiology of cleft lip (CL) and cleft palate (CLP) has not previously been described in the context of the Bhutan and Bhutanese populations. Using National Birth Defects Surveillance Data and other vital statistics, we present the comprehensive epidemiology of the cleft lip and palate in Bhutan. The National Birth Defects Surveillance Data Registry from 2015 to 2022 is reviewed retrospectively, covering 8 years of birth defect surveillance in the country from records maintained with three referral hospitals in the country. The baseline prevalence and incidence of cleft lip and palate have been presented over the years. The incidence of cleft lip and palate was defined as the number of cases per 1000 live births. We used Poisson's regression to compute the incidence of cleft lip and palate. Pearson chi-square tests (χ2) were used to examine the associations of maternal and child characteristics with cleft lip and palate. A total of 1401 newborns with various birth defects were born among the 89,078 live births from 2015 to 2022 in Bhutan. Of these, 122 (8.7%) constituted orofacial clefts. The prevalence of orofacial clefts tended to increase, with a period prevalence of 1.37 per 1000 live births. There were more cases in males (72) than in females (50). The incidence rate ratio ranged from 1.2 to 2.0 compared with the 2015 baseline year, indicating increased rates over time. Orofacial clefts constituted 8.7% of total birth defects and 1.37 per 1000 live births over the years. The increasing prevalence trends and incidence rate ratios over the years underscore the importance of ongoing surveillance and interventions to address the burden of orofacial clefts in Bhutan. Not applicable.

Research on the influence of different factors on the incidence of cleft lip in children Taking Xinjiang as an Example

Cleft lip and palate have always been the focus of children's medical research. This paper focuses on various environmental factors, such as the frequency of pregnant women taking prescription medicine, family medical history, and the financial status of the families. To conduct the study, this study will collect a sample of several hundred children with cleft lips and palates, utilizing existing research papers as a data source. The paper focuses on the effect of environmental factors on the incidence rate of children with cleft lips and palates in Xinjiang through literature reading. As the results show, there is statistical significance between environmental factors and the incidence rate of children with cleft lips and palates in Xinjiang. Specifically, consanguineous marriage, medicine consumption during pregnancy, disadvantageous climatic and geographic factors, and a lack of educational background all contribute to increasing the prevalence of children with CL/P among the Uyghur people.

Incidence of cleft lip and palate, and epidemiology of perinatal deaths related to cleft lip and palate in Hunan Province, China, 2016–2020

This study aimed to analyze the epidemiological characteristics of cleft lip and/or palate (CL/P) and CL/P-related perinatal deaths, provide some information for intervention programs to reduce the incidence of CL/P and provide clues for future researchers. Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. Incidences of CL/P [number of cases per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond)] with 95% confidence intervals (CI) were calculated by residence, gender, maternal age, year, and major types [cleft lip only (CL), cleft palate only (CP), and cleft lip with palate (CLP)]. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with CL/P. Pearson chi-square tests (χ2) were used to examine the association of each maternal characteristic with CL/P-related perinatal deaths. A total of 847,755 fetuses were registered, and 14,459 birth defects were identified, including 685 CL/P (accounted for 4.74% of all birth defects). CL, CP, and CLP accounted for 24.67% (169 cases), 36.79% (252 cases), and 38.54% (264 cases) of all CL/P, respectively. The incidence of CL/P was 0.81‰ (95%CI 0.75–0.87). The incidence of CL was 0.20‰ (95%CI 0.17–0.23) (169 cases), of CP was 0.30‰ (95%CI 0.26–0.33) (252 cases), and of CLP was 0.31‰ (95%CI 0.27–0.35) (264 cases). CL was more common in males than females (0.24‰ vs. 0.15‰, OR = 1.62, 95%CI 1.18–2.22). CP was more common in urban than rural (0.36‰ vs. 0.25‰, OR = 1.43, 95%CI 1.12–1.83), and less common in males than females (0.22‰ vs. 0.38‰, OR = 0.59, 95%CI 0.46–0.75). CLP was more common in males than females (0.35‰ vs. 0.26‰, OR = 1.36, 95%CI 1.06–1.74). Compared to mothers 25–29 years old, mothers < 20 years old were risk factors for CLP (OR = 3.62, 95%CI 2.07–6.33) and CL/P (OR = 1.80, 95%CI 1.13–2.86), and mothers ≥ 35 years old was a risk factor for CLP (OR = 1.43, 95%CI 1.01–2.02). CL/P-related perinatal deaths accounted for 24.96% (171/685) of all CL/P, of which 90.64% (155/171) were terminations of pregnancy. Rural residents, low income, low maternal age, and early prenatal diagnosis are risk factors for perinatal death. In conclusion, we found that CP was more common in urban areas and females, CL and CLP were more common in males, and CL/P was more common in mothers < 20 or ≥ 35 years old. In addition, most CL/P-related perinatal deaths were terminations of pregnancy. CL/P-related perinatal deaths were more common in rural areas, and the proportion of CL/P-related perinatal deaths decreased with the increase in maternal age, parity, and per-capita annual income. Several mechanisms have been proposed to explain these phenomena. Our study is the first systematic research on CL/P and CL/P-related perinatal deaths based on birth defects surveillance. It is significant for intervention programs to prevent CL/P and CL/P-related perinatal deaths. As well, more epidemiological characteristics of CL/P (such as the location of CL/P) and approaches to reduce CL/P-related perinatal deaths need to be studied in the future.

Assessment of Incidence of Aspiration Pneumonia in Infants with Cleft Palate

Background: A cleft lip (CP) is characterized by a split in upper lip, which may extend into the nose. These abnormal fissures can cause difficulties with nutrition, hearing, speaking and recurrent respiratory and ear infections. Objectives: The study assessed the complications associated with the cleft palate in infants and the incidence of aspiration pneumonia. Methods: The study was conducted in tertiary care hospitals and pediatric clinics at District Dera Ismail Khan, from February 2021 to September 2022, comprising 141 CP patients. Results: The incidence of CP was seen 7.90% in District Dera Ismail Khan, which was higher in males (68.08%) than in females (31.91%). The mean age of the study group was 4.35+3.12, with birth weight and weight at the time of assessment being 3.85+1.78 and 23.78+15.19, respectively. Their mean maternal age and weight at the time of delivery were 32.91+9.07 and 61.65+21.56, respectively. A significant proportion (p&lt;0.05) suffered from aspiration pneumonia (64.53%), while 19.85% of the patients had complained of recurrent pneumonia due to CP. Other complications included chest infection (43.26%), ear infection (8.51%), nasal obstruction (31.91%), vomiting during feeding (26.95%) and regurgitation of milk and other food materials (12.05%). Ten CP patients died (7.09%) due to the complications associated with this disorder. Practical implications: For infants with orofacial clefts, the incidence of LRTIs is potentially high, thus accumulated breastfeeding length might mediate the connections of CP. Conclusion: It was concluded that CP was significantly associated with pulmonary defects and caused fatal LRTIs in the affected population, especially in breastfeeding infants. Keywords: Cleft palate; Ear infections; Fetal defects; Genetic Disorders; Pulmonary infections.

Prevalence of Cleft Lip and Palate in the Developing Countries of Asia and Africa: A Review

Introduction: The objective of this paper is to review the literature on the incidence of cleft lip and palate (CLP) in the developing countries of Asia and Africa. The existing literature tends to focus on developed countries and there is lack of research in developing countries. Methods: The studies that met the inclusion criteria were reviewed and data extracted. There were 20 studies done in Asian and African countries which were included. Results: The incidence of CLP in Asian countries is markedly greater than in African countries. Most studies report a male predominance in CLPs and a female predominance in cleft palates. The male dominance is seen more than other developing countries which is consistent with other Asian countries and the same has been found in African countries. In the Nepalese study, females were slightly more affected than males among all clefts. The incidence or prevalence in the frequency and types of malformations of CLP in developing countries has been provided. Conclusions: The review underlines the need for an aggressive approach to prevent and control CLP in patients in developing countries.

The Evaluation of Hospital Social Responsibility Services in Gatot Soebroto Indonesia Central Army Hospital in 2015 – 2019 of Cleft Lip and Palate Patients

Background : Cleft lip and cleft palate are the most common congenital craniofacial anomalies treated by plastic surgeons. The incidence of cleft lip and palate is higher at lower socioeconomic levels. Hospital Social Responsibility (HSR) in Gatot Soebroto Central Army Hospital provides free cleft lip and palate surgeries to those who need it the most. The HSR services still need to be evaluated, to get an overview of epidemiologic profile of cleft lip and palate patients, and to improve the services itself. Materials and Method: The authors conducted a retrospective descriptive study based on online data of Smile Train HSR RSPAD Cleft Center from period of January 2015 to December 2019. All patients presented with cleft lip and/or palate were included. Results : Of all 713 patients in total; The gender distribution male 62.2% (444/713) was higher than female 37.7% (269/713). Most of the patients came from Java Island 77.5% (553/713). 685 were primary surgeries, 28 secondary surgeries. Among the primary surgeries, lip repair has the highest numbers 71.6% (491/685), followed by palate repair 27.2% (187/685), and alveolar bone grafting 1% (7/685). The most widely used surgical technique in lip surgery was the Millard 50% (345/685), while the most widely used surgical technique in palate surgery was the Bardach technique 22.9% (157/685). The median age for the primary lip repair patients was 1 year (range, 3 months to 60 years), and the median age for the primary palate repair patients was 4 year (range, 7 months to 26 years). Among secondary surgeries, lip revision with Millard technique was the highest (82.1%), followed by scar revision 3.57%, fistula repair (7.1%). The most common diagnosis was unilateral cleft lip (left 34.4%, right 13.2%) and followed by complete cleft palate (22.7%) Conclusion : Male patients were more dominant than females. The most common diagnosis was unilateral cleft lip. Incomplete diagnostic data and clinical photos of patients make it difficult to determine the complete diagnose of cleft lip and palate.

Clinical Epidemiological Study of Children with Cleft Lip and Palate

Aim: To determine the frequency of different types of cleft lip and palate and to investigate the possible relation of some risk factors to cleft lip and palate. Study design: Descriptive study. Place and duration of study: Peshawar Dental College, Peshawar Pakistan from 1st August 2017 to 31st January 2019. Methodology: One hundred and seven patients with congenital cleft lip and cleft palate deformities, either gender and age ranged from 1 day to 720 days were enrolled. Cleft types were categorized as bilateral cleft lip and palate (BCLP), left cleft lip and palate (LCLP), right cleft lip and palate (RCLP), cleft alveolus (CLA) and bilateral incomplete cleft (BICLP). Results: There were 73(68.2%) males and 34(31.8%) females. The highest number of patients from Peshawar 30(28%) followed by Swat 21(19.8%) and Charssada by 11(10.3%). Forty two (39.3%) patients’ parents had consanguineous marriages. There were 89(83.2%) of mother haven't used folic acid during their pregnancy. Forty 40(37.4%) cases had a positive family history of cleft deformities. Most common systemic disease was anemia 25(23.2). Eighty five (79.4%) of cleft lip and palate patients were belonging to poor class family. Conclusion: The households of cleft lip and palate children demonstrated low socioeconomic status. The incidence of cleft lip and palate should be reduced to enhance the conditions of women during pregnancy by maintaining a balanced diet and giving them folic acid. Keywords: Epidemiology, Children, Cleft lip, Palate, Risk factors

Cleft lip and palate based on birth order and family history at Mitra Sejati General Hospital, Indonesia

Background: Cleft lip and palate is one of the most common congenital abnormalities in infants and is caused by more than one factors, which can be genetic and environmental. Defects in a family gene can result in cleft lip and palate. The study found a high family history relationship with the incidence of cleft lip and palate. Birth order studied by several researchers also has different results, which were influenced by folic acid consumption, maternal knowledge, lack of antenatal care visits and maternal age. To determine the cases of cleft lip and palate based on the birth order of the children and family history of the patients at Mitra Sejati General Hospital. Purpose: The study aimed to investigate cleft lip and cleft palate patients by birth order and family history. Methods: This research was a retrospective descriptive study using survey method. Researchers gave 13 questions through a questionnaire and data were collected and counted manually. Results: The results showed that based on the birth, the cleft case in the first birth order amounted to 25 people, the second 30 people, the third 19 people, and the fourth or more as many as 20 people. Based on family history, 27 patients had a family history of cleft lip and palate, while 67 patients did not have family history. Conclusion: The cases of clefts at Mitra Sejati General Hospital happened more frequently in the second child and most incidence did not have family history.

Study intelligence quotient among sample of children suffering from cleft lip and palate &amp; hypospadias attending pediatric surgery clinic in Al-Hussien Hospital

Background: need for more reliable knowledge about speech development &amp; surgical techniques is critical in caring for children born with cleft lip &amp; palate. Aim and objectives: The main goal of this research was to assess the level of intelligence in children born with cleft lip &amp; palate and hypospadias and to find if there is correlation among cleft lip &amp; palate &amp; hypospadias malformations and IQ. Subjects &amp; methods: This cross-sectional research was conducted in pediatric surgery clinics at Al-Azhar University Hospitals. Research was showed on 52 children with cleft lip &amp; palate and hypospadias. All patients were divided into 2 groups: Cleft lip &amp; palate group (n=30) &amp; Hypospadias group (n=22). Results: regarding Full-Scale Intelligence Quotient of Wechsler Intelligence Scale of studied children. Full-Scale Intelligence in Cleft lip and palate group ranged from 72 to 104 with mean ± SD = 86.4 ± 7.56 while in Hypospadias group the Full-Scale Intelligence ranged from 66 to 99 with mean ± SD = 86.18 ± 8.02. Conclusion: The present study assessed the association between intelligence level and incidence of cleft lip &amp; palate &amp; hypospadias.

The Correlation between High-Risk Pregnancy &gt; 35 Years Old with Labioschizis Congenital Disorders

Abnormalities of the lip and palate or commonly referred to as cleft lip or labioschizis, are congenital abnormalities of the gap between the right and/or left sides of the lip. Palatoschizis is the most common congenital abnormality after labioschizis with multifactorial causes and is found in every nation in the world. This congenital anomaly is ranked the third most common based on a survey conducted in 13 major hospitals in Indonesia, and the incidence of cleft lip with or without cleft palate is 1 per 700-1000 births worldwide, and Asians have the highest risk. Among the factors causing it, genetics is agreed to be the main factor. Infants die or are disabled; even mothers die during childbirth, which often occurs in pregnancies aged &gt; 35 years and over. Giving birth at the age of &gt; 35 years and over, babies born are susceptible to genetic disorders. This study is to report cleft lip due to high-risk pregnancy &gt; 35 years old at regional public hospital Drs. H. Amri Tambunan, Deli Serdang, which is a type B regional hospital in North Sumatra, Indonesia. This was a descriptive analysis with the cross-sectional retrospective study by using medical records of high-risk pregnancy &gt; 35 years old patients treated from January to December 2019. The data are presented in tabular and pie form. In this study, there were 86 samples of patients with high-risk pregnancies &gt; 35 years, and there were 49 (56.9%) patients in this study. The highest incidence rate was congenital cleft lip in 39 (45.3%) patients. Operations on children with congenital abnormalities such as labioschizis, labiopalatoschizis, and labiopalatognatoschizis are mostly performed when children are &gt; 3 months – 12 months old, as many as 11 (28.2%) patients while 16 (41.1%) patients do not have surgery in this research. The results of this study did not show a relationship between the age of pregnant women &gt; 35 years with the incidence of abnormalities under the cleft lip with a p-value of 0.230 which means a sig value &gt; 0.05. However, based on the data that researchers got, respondents with maternal age of &gt; 35 years tend to experience labioschizis, meaning that the older the age of pregnant women, the riskier they give birth to babies with labioschizis.

Association of maternal folic acid supplementation and incidence of non-syndromic cleft lip and palate

Background: Cleft lip and palate as a frequent congenital defect is caused by genetic and environmental factors. Micronutrient folic acid as an environmental factor has shown a role as a cleft lip and palate protective factor in several previous studies. Purpose: The purpose of this study was to determine the distribution of adequacy of folic acid supplementation and the association between folic acid supplementation during the first trimester of pregnancy with the incidence of cleft lip and palate at Mitra Sejati Hospital, Medan, North Sumatra, Indonesia. Methods: This study used analytical research with a case-control design and questionnaire. A Chi-square test was used to observe the association between the folic acid supplement intake during the first trimester with the incidence of cleft. The p-value ≤ 0.05 was deemed to be significant. Results: The study found that 47 mothers (51.09%) had insufficient, while 45 mothers (48.91%) had adequate folic acid supplementation. This study did not show a significant association between supplement use and all cleft incidence (p&gt;0.05), but a significant result was found between inadequate supplementation (&lt;400µ/day) and cleft lip with or without cleft palate occurrence (p=0.043; OR 2.4[1.022-5.625]). Conclusion: The present study showed that most pregnant women did not have sufficient folic acid supplement in the first trimester. Furthermore, inadequate maternal folic acid supplementation (&lt;400µ/day) during the first trimester of pregnancy increased the tendency for cleft lip and cleft palate (with or without cleft lip) to occur significantly.

Poverty and Risk of Cleft Lip and Palate: An Analysis of United States Birth Data.

The relationship between poverty and incidence of cleft lip and cleft palate remains unclear. The authors investigated the association between socioeconomic status and cleft lip with or without cleft palate and cleft palate only in the United States after controlling for demographic and environmental risk factors. The U.S. 2016 and 2017 natality data were utilized. Proxies for socioeconomic status included maternal education, use of the Special Supplemental Nutrition Program for Women, Infants, and Children, and payment source for delivery. Multiple logistic regression controlled for household demographics, prenatal care, maternal health, and infant characteristics. Of 6,251,308 live births included, 2984 (0.05 percent) had cleft lip with or without cleft palate and 1180 (0.02 percent) had cleft palate only. Maternal education of bachelor's degree or higher was protective against, and delayed prenatal care associated with, cleft lip with or without cleft palate (adjusted ORs = 0.73 and 1.14 to 1.23, respectively; p < 0.02). Receiving assistance under the Special Supplemental Nutrition Program for Women, Infants, and Children was associated with cleft palate only (adjusted OR = 1.25; p = 0.003). Male sex, first-trimester tobacco smoking, and maternal gestational diabetes were also associated with cleft lip with or without cleft palate (adjusted ORs = 1.60, 1.01, and 1.19, respectively; p < 0.05). Female sex, prepregnancy tobacco smoking, and maternal infections during pregnancy were associated with cleft palate only (adjusted ORs = 0.74, 1.02, and 1.60, respectively; p < 0.05). Increased incidence of orofacial clefts was associated with indicators of lower socioeconomic status, with different indicators associated with different cleft phenotypes. Notably, early prenatal care was protective against the development of cleft lip with or without cleft palate. Risk, III.

Role of proteins in MAPK pathways on Cleft Lip Patients of Protomalayid Race in East Nusa Tenggara Province, Indonesia

Cleft lip is a disruption which happens in the upper lip joining process due to multifactorial causes such as genetic, nutritional, environmental, and socio-economic. East Nusa Tenggara is a province in Indonesia with Protomalayid race population that has a high incidence of cleft lip of 5-6 per 1000 births. This study therefore aims to determine the expression and relationship of proteins in the Mitogen-activated Protein Kinase (MAPK) pathway of cleft lip in the Protomalayid race of East Nusa Tenggara Province. The method used was Hematoxylin-Eosin staining and Immunohistochemical technique to identify the expression of Transforming Growth Factor Alpha (TGF-α) protein, Extracellular signal-regulated kinases (ERK1), Activator Protein (AP-1), Transforming Growth Factor Beta-1 (TGF-β1), p38, Soluble Vascular Endothelial Growth Factor Receptor 1 (sVEGFR1), Epidermal Growth Factor Receptor (EGFR), and Fibroblast Growth Factor 2 (FGF- 2) in cleft lip cells. The result shows that the expressions of TGF-α, EGFR, FGF-2, and ERK-1 decreased, but that of AP-1, TGF-β1, p38, and SVEGFR1 increased. Meanwhile, the results of the Pearson correlation analysis showed the TGFα-ERK1, TGFβ1-p38, AP1-p38, EGFR-ERK1, and FGF2-p38 had a positive relationship. All the factors in the study have correlations (except FGF2 - ERK1). The relationship between FGF2-ERK1 was not significant, while SVEGFR1- p38 protein has a negative relationship.

Orthognathic Surgery Combined with Orthodontic Treatment in a Patient with Bilateral Cleft Lip, Palate and Alveolus, Without Alveolar Bone Graft: A Case Report

Background: The incidence of cleft lip and palate is 8 in every 10,000 live births. A patient with this condition experiences a deficiency in maxillary growth. Maxillary hypoplasia leads to malocclusion and skeletal disharmony. Orthognathic surgery at skeletal maturity is the standard procedure at the end of the protocol to correct maxillary hypoplasia resulting in malocclusion not correctable with orthodontics alone.Case Presentation and Operation Technique: We report the result of orthognathic surgery performed on a 23 year old male with complete bilateral cleft lip, palate, and alveolus. We proceeded with bimaxillary surgery despite the alveolar cleft. We also recorded a neglected alveolar cleft in which he should have had undergone alveolar bone graft prior to the current procedure. The pre-maxillary segment was stabilized with miniplate followed by Le Fort 1 advancement and mandibular setback guided by an occlusal wafer. Malar augmentation was done by onlay bone grafts. Mandibulo-maxillary fixation was maintained. Postoperatively, a good occlusion and better facial harmony were achieved. He was planned to undergo a septorhinoplasty in the near future.Discussion: Despite adequate treatments following the protocol recommended by many centres, some patients developed some degree of maxillary hypoplasia. A quarter of this population need osteotomies and Le Fort I maxillary osteotomy is the most common procedure to correct retrognathic maxilla.Conclusion: Orthognathic surgery combined with orthodontic treatment in a patient with bilateral cleft lip and palate provided good functional and aesthetic result. However, this procedure cannot replace the standard protocol of having an alveolar bone graft performed before permanent canine eruption to achieve optimal outcomes

Incidence of Bilateral Cleft Lip And Palate In A University Hospital Setting-A Retrospective Study

Cleft lip and palate (CLP) is one of the most prevalent malformations occurring in the head and neck region. Cleft lip and palate is the second most birth defect in the US after club foot. The incidence of Cleft lip and cleft palate is also very common in Indian Population with the rate of 1 in 700 births approximately. In India, the main reason for the formation of Cleft Lip and cleft palate is consanguineous marriage due to less awareness among people. Cleft lip can be unilateral or bilateral and may involve or palate. Again it can be further classified as Complete or Incomplete cleft lip and /or Cleft palate. Most of the patients were deprived of treatment, mainly due to their unawareness and their lower status. Cleft patients need comprehensive, cleft care management. So the aim of this study is to find the incidence of bilateral cleft lip or palate in patients who reported toSaveetha Dental College and Hospital, Chennai. This study is done with 76 patients40 males, 36 females)who visited a Saveetha Dental College during one year between June 2019-April 2020. All available data were extracted from patients case sheets and results were obtained through SPSS analysis. In this study, we observed that 90.5 % of patients reported with unilateral cleft lip and palate, where only 9.1% of patients reported with bilateral cases. Males were having high prevalence with 52.6 % and females 47.4%. conclusion, male patients had higher cleft lip and palate compared to females. The incidence of bilateral cases seen among cleft lip and palate is fewer in males.

Hubungan Antara Ibu Hamil Usia ≥ 35 Tahun dengan Kejadian Labioschizis

Abnormalities lip and palate or cleft lip commonly called congenital abnormality or labioschizis is a gap between the right and/or left lip. The incidence of cleft lip with or without cleft palate is one per 700-1000 births worldwide and Asians have the highest risk. Infant death or disability, even the mother died during childbirth in pregnancy aged 35 years and over. Giving birth at the age of 35 years and over, babies who are born susceptible to genetic abnormalities. The purpose of this study was to determine the relationship between maternal age of ≥35 years with labioschizis incident. This study used cross-sectional design: Retrospective, data was collected from the medical records during the period 1 January 2018 to 31 December 2018. The number of samples of 138 respondents, data was analyzed using the chi-square test with a significance level of ρvalue &lt; 0.05. The results showed that most respondents had labioschizis namely 65.9%, while 34.1% of respondents experienced palatoschizis and labiognatoschizis. The lives of most mothers with children experiencing labioschizis are ≥35 years of age is 57.1%. The results of the study there was no correlation between a maternal age ≥ 35 years with the incidence labioschizis with value 0.793 ρvalue means sig &gt;0.05. However, based on the data that researchers get the respondent with maternal age of 35 years tend to have labioschizis, meaning that the older a pregnant woman would be more risk of having babies with labioschizis.

War in the Middle East and the Incidence of Cleft Lip and Palate.

The aim of this retrospective study was to study the effects of the war against ISIS during period (2014-2018) on the incidence of cleft lip and palate and the appearance of different congenital anomalies. The collected sample consists of 320 newborn babies (160 patients and 160 infants as a control). The examined patients and controls were all included in this study, while the authors exclude those who born to relative parents, and if the mothers had taken any medications during pregnancy.All newborn cases and controls were physically examined by the research team, and a questionnaire was completed after obtaining the informed consent of mothers and/or fathers. In this study, the authors found that 160 patients out of 40,500 live births were born with cleft lip and/or cleft palate, so their percentage was 0.39% from population, that is mean approximately 4 infants affected per each 1000 live births. The risk of cleft development among children who born to fathers who participated in long fighting against the terrorists was (OR = 44.333, 95% CI: 20.176-97.417). The associated combined anomalies were found in 88 patients (79%) especially among those whom fathers participated in the war CONCLUSION:: From this study the authors can conclude that the dramatic increase in the incidence of cleft lip and palate and the appearance of different associated anomalies in the south of Iraq is due to the direct effect and impact of the war and the used toxic bombs on the chromosomal changes of the parents and the developing fetus.

A retrospective hospital based study on factors influencing the incidence of cleft lip and palate cases in Bihar region

Introduction: Cleft lip and palate are most common developmental anomaly of head and neck region affecting a great number of newborns worldwide. Further it gives rise to psychosocial and financial strain to the affected family especially in developing countries like India. The exact etiology and pathogenesis of cleft lip and palate is still an enigma and behave as a complex process involving several genetic and environmental factors. Objective: To assess the pattern of cleft lip and palate cases and to analyze if any relation to environmental factors present in Bihar region. Materials and Methods: This retrospective study was conducted in Government Hospital of Patna, Bihar through evaluating the recorded medical files of cleft lip and palate cases of 5 years duration and self designed data forms were filled. Results: Results were obtained through analyzing the obtained data and were tabulated. Percentage and frequency was evaluated to assess the pattern of incidence of such anomalies. Conclusion: The present study is in favor of conceptualization of multifactorial theory involved in occurrence of cleft lip and palate. Furthermore, it also provides a baseline data for future reference which might help in conducting any researches on this particular area. Keywords: Cleft lip, Cleft palate, Factors, Incidence, Retrospective.

Analysis of the Prevalence and Incidence of Cleft Lip and Palate in Colombia.

To analyze the population prevalence and birth prevalence of oral clefts in Colombia from 2009 to 2017. A cross-sectional study using information from the National Administrative Records of Colombia. The data came from 2 types of administrative records (Surveillance System and the Individual Registry of Service Provision) and the oral health national survey. Population prevalence and birth prevalence by type of cleft lip and/or cleft (CL/P) ratios were calculated using Poisson distribution for count data and to assess stationary tests on time series (Dickey-Fuller) and (Phillips-Perron) was used. Population prevalence in Colombia was 3.27 per 10 000 inhabitants (95% confidence interval [CI], 3.21-3.32) and birth prevalence was 6.0 per 10 000 live births (95% CI, 5.67-6.35). Bogotá have the highest population prevalence with CL/P. In the analysis of trends for the prevalence proportion by type of clefts in newborn babies with cleft, it was observed that the highest proportion was for babies with CLP. Cleft lip (CL) has increased from 17.4% in 2014 to 34.2% in 2017, cleft palate (CP) has decreased from 32.9% to 20.2%; and CLP changed from 49.6% to 45.5% in the same period. The population prevalence was 3.27 per 10 000 inhabitants. Births prevalence was 6.0 per 10 000 live births, and Orinoquia and Amazonia have higher rates than the national average. The administrative registers are adequate systems to know the behavior of oral clefts. The CL/P had a nonstationary trend during the period 2014 to 2017.

Incidence patterns of orofacial clefts in purebred dogs.

Cleft lip (CL), cleft palate (CP) and cleft lip and palate (CLP) are the most common types of orofacial clefts in dogs. Orofacial clefts in dogs are clinically relevant because of the associated morbidity and high newborn mortality rate and are of interest as comparative models of disease. However, the incidence of CL, CP and CLP has not been investigated in purebred dogs, and the financial impact on breeders is unknown. The aims of this study were to document the incidence patterns of CL, CP and CLP in different breeds of dogs, determine whether defect phenotype is associated with skull type, genetic cluster and geographic location, and estimate the financial impact in breeding programs in the United States by means of an anonymous online survey. A total of 228 orofacial clefts were reported among 7,429 puppies whelped in the 12 preceding months. Breeds in the mastiff/terrier genetic cluster and brachycephalic breeds were predisposed to orofacial clefts. Certain breeds in the ancient genetic cluster were at increased odds of orofacial clefts. Male purebred dogs were at increased odds of CPs. Results confirm that brachycephalic breeds are overrepresented among cases of orofacial clefts. Furthermore, geographic region appeared to be a relevant risk factor and orofacial clefts represented a considerable financial loss to breeders. Improved understanding of the epidemiology of orofacial clefts (frequency, causes, predictors and risk factors) may help in identifying ways to minimize their occurrence. Information gained may potentially help veterinarians and researchers to diagnose, treat and prevent orofacial clefts.