Incidence Of Orofacial Clefts Research Articles

Epidemiologic Trends of Cleft Lip and Palate in a Southern State: A 30-Year Follow-Up.

Children's of Mississippi at the University of Mississippi Medical Center serves as the state's only American Cleft Palate-Craniofacial Association-approved cleft team at the only pediatric hospital in the state. The goal of this study is to report geographic and demographic patterns of patients with orofacial cleft (OFC) treated at Children's of Mississippi, which are lacking. Patients with OFC treated at Children's of Mississippi from 2015 to 2020 were included. Demographic data were collected, including birth county and total live births from state data. Significant differences between incidence of OFC among public health regions of Mississippi were examined using analysis of variance (P < 0.05). Cases were compared with historical data from 1980 to 1989. There were 184 patients who presented with OFC, with a statewide incidence of 0.83 per 1000 live births among 222,819 live births in the state across 6 years. The incidence of OFC was 0.83/1000 for Whites and 0.82/1000 for non-Whites versus a historical rate of 1.36 and 0.54, respectively. Significantly fewer children in the northern region (0.25/1000) were born with OFC than in central (1.21; P < 0.001) and southern (0.86; P < 0.001) regions. Results from this study suggest changing regional patterns of OFC in Mississippi. Although rates increased among non-White infants, the overall incidence of OFC has decreased compared with historical data. The findings may reflect actual incidence patterns in the state or the proximity of certain regions to Children's of Mississippi. Further study may reveal regional differences in risk factors underlying OFC incidence, and/or issues with access to cleft care for different regions in the state.

The Impact of Geographic and Socio-Demographic Factors on the Incidence of Orofacial Clefts in the United States

The Impact of Geographic and Socio-Demographic Factors on the Incidence of Orofacial Clefts in the United States

Management of orofacial clefts in Africa, insufficient management centers, and workforce.

Management of orofacial clefts in Africa, insufficient management centers, and workforce.

External Structural Congenital Anomalies Diagnosed at Birth in Tamale Teaching Hospital

Background: In the year 2013, about 276,000 of the 2.71 million neonatal deaths were directly attributable to congenital anomalies of which an estimated 95%, occurred in low and middle-income countries.Materials and method: This study was part of surveillance on external structural congenital anomalies conducted in the Tamale teaching hospital from 1st January 2011 to 31st December 2015. Aggregate data on maternal characteristics and outcome of deliverywere collected from the records in the antenatal clinics, labour and delivery room, and midwifery monthly returns.Results: A total of 35,383 live births were recorded in the study. Overall, 161 external congenital anomalies were recorded over the period. The overall incidence of external congenital anomalies over the five-year period was 455 per 100,000 live births. The gastrointestinal (GIT) system accounted for (77) 47.8%, Central nervous system (65) 40.4%, Major musculoskeletal (9) 5.6%, Genitourinary system about (2) 1.2%, Multisystemic and syndromes accounted for (8) 5.0% of all external structural congenital anomalies. The incidence of specific congenital anomalies found during the study period were as follows; Spina bifida 104.6 per 100,000 live births, Exomphalus/omphalocele 84.8 per 100,000 live births and Anencephaly 5.7 per 100,000 live births. The incidenceof Oro-facial cleft, Hydrocephalus and Imperforate anus were 73.5, 48.0 and 39.6 per 100,000 live births respectively.Conclusion: External structural congenital anomalies rate in the northern sector of Ghana is unacceptably high. Trend analysis has demonstrated the steady decline in neural tube defects.

Maternal Common Cold or Fever During Pregnancy and the Risk of Orofacial Clefts in the Offspring: A Systematic Review and Meta-analysis.

The common cold and/or an associated fever during pregnancy have/has been suspected to harm the developing fetus. We sought possible correlations between a maternal common cold or fever during pregnancy and the risk of orofacial clefts in the offspring. We systematically searched PubMed and Embase using appropriate keywords, and we checked the reference lists of retrieved articles. We used random-effects models to estimate overall relative risks. Incidence of orofacial clefts. We included 13 case-control studies. Modest but statistically significant associations were found between a maternal common cold and cleft lip with or without a cleft palate (CL/CP) (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.66–2.83) and a cleft palate only (CPO) (OR 3.08; 95% CI 1.5–6.34). Furthermore, maternal fever was also associated with an increased risk of CL/CP (OR 1.91, 95% CI 1.3–2.8) and CPO (OR 1.48, 95% CI 0.83–2.63) in the offspring. Further analyses of maternal influenza (alone) yielded similar results. Although evidence of heterogeneity should be carefully evaluated, our findings suggest that maternal common cold or fever during pregnancy may be associated with a greater risk of CL/CP or CPO in the offspring. Future cohort studies using valid assessments of maternal common cold exposure during pregnancy that consider the severity of fever are needed to clarify the contribution of maternal common cold or fever status to the risk of orofacial clefts in children.

The Association Between Influenza Infection Rates and the Incidence of Orofacial Clefts in the United States

Objective: To investigate seasonal variation of orofacial clefts (OC) and measure association between United States (U.S.) influenza incidences and OC development for the purpose of identifying a potential modifiable risk factor for pregnant women. Design: Retrospective population-based observational study from 2004 to 2013. Setting: National Inpatient Sample Database (NIS), Wide-ranging Online Data for Epidemiologic Research (WONDER) Database, and National Respiratory and Enteric Virus Surveillance System’s (NRVESS) FluView database. Patients: U.S.-born infants with OC from 2004 to 2013 and monthly influenza incidence from 2003 to 2013. Main outcome measures: Using logistic regression, monthly odds ratios (OR) of OC were derived using January as baseline. Mixed-effects logistic regression was utilized to test association between national influenza and OC incidences. Results: There were 58 270 U.S. babies born with OC from 2004 to 2013. September births had the highest OC association (OR = 1.094, 95% CI = 1.051-1.138, E-value = 1.41), followed by June. For each additional influenza case per 1000 people, odds of OC event occurring during the 2nd month of pregnancy, or 7 months before delivery, was increased by 2.7 (OR = 2.659, CI = 1.456-4.856, E-value = 4.76). Odds of OC event occurring was decreased at the 3rd month of pregnancy, or 6 months before delivery by 7.8 (OR = 0.129, 95% CI = 0.068-0.246, E-value = 14.99). Conclusion: September and June births have the highest OC association. There is increased risk for OC with influenza occurring at the 2nd pregnancy month. Conversely, there are protective effects against OC with influenza occurring at the 3rd pregnancy month. These findings demonstrate an association between influenza rate and OC, suggesting a connection between maternal immune activation (mIA) and OC. Although further research is needed to determine the definitive link between the use of flu vaccines and OC occurrence, as well as the mechanism behind mIA secondary to influenza infection impacting OC incidence, this study presents a modifiable risk factor that could decrease the potential for mIA causing OC.

Incidence, Risk Factors, and Mortality Associated With Orofacial Cleft Among Children in Ontario, Canada

Orofacial cleft (OFC) is one of the most common congenital malformations, with a wide variation in incidence worldwide. However, population-based studies on the incidence of OFC in North America are lacking. To examine the incidence of OFC in Ontario, Canada, and to compare risk factors and mortality associated with children with OFC vs children without OFC. This population-based retrospective cohort study used health administrative data from the province of Ontario, Canada. Children with OFC who were born from April 1, 1994, to March 31, 2017, in Ontario were each matched to 5 children without OFC based on sex, date of birth (±30 days), and mother's age (±5 years). Analyses were conducted from September 2018 to January 2019. Children born with OFC. Incidence of OFC over time and regional variation. Risk factors for OFC were assessed using 1-way analysis of variance for means, Kruskal-Wallis for medians, and χ2 tests for categorical variables. Adjusted Cox regression models were used to assess mortality. From 1994 to 2017, 3262 children were born with OFC in Ontario, Canada, and they were matched to 15 222 children born without OFC. Incidence of OFC in Ontario was 1.12 cases per 1000 live births, with wide geographic variation and a lower incidence from 2004 to 2017 compared with 1994 to 2003 (1.02 vs 1.13 cases per 1000 live births; P = .002), especially for the subgroup with cleft palate (0.52 vs 0.44 cases per 1000 live births; P = .006). Children with OFC, compared with children without OFC, were more likely to be born prematurely (406 children [13.3%] vs 1086 children [7.1%]; P < .001; standardized difference, 0.21) and had lower mean (SD) birth weight (3215.3 [687.6] g vs 3382.6 [580.0] g; P < .001; standardized difference, 0.26). The mortality rate among children with OFC was higher than among matched children without OFC (hazard ratio, 10.60; 95% CI, 7.79-14.44; P < .001). When mortality was adjusted for the presence of congenital or chromosomal anomalies, the risk of death was not significantly different between children with OFC and those without OFC (hazard ratio, 1.35; 95% CI, 0.73-2.72). These findings suggest that incidence of OFC In Ontario, Canada, decreased from 1994 to 2017. Mortality in children with OFC was high, especially in the first 2 years of life, and was predominantly associated with the presence of other congenital or chromosomal anomalies. Further research is required to better understand the causes of wide geographical variations of OFC incidence and improve the survival of these patients.

Incidence and Demographic Patterns of Orofacial Clefts in Mysuru, Karnataka, India: A Hospital-based Study.

ObjectiveThe study was conducted to know the incidence and trends of orofacial clefts between 1st January 2011 and 31st August 2016 in Mysuru, Karnataka; and to describe the demographic patterns.Materials and methodsThis is a retrospective, hospital-based study. Data were retrieved from multiple sources like Parturition books, Neonatal intensive care unit records, baby and mothers case records archived in medical records department of Cheluvamba Hospital, a Tertiary Care Government Hospital, attached to Mysore Medical College and Research Institute, Mysore, Karnataka, between 1 January 2011 and 31 August 2016. All subjects with CL ± P were included in the study. Data were collected using semi-structured proforma, designed based on the review of the literature. Prior to the study, approval of the Institutional Ethics Committee was obtained. Collected data were subjected to descriptive statistical analysis using SPSS version 21 (SPSS Inc.).ResultsA total of 59 children with CL ± P were born between 1 January 2011 and 31 August 2016 among 77667 births (Male: 36,625; Females: 41042). Hence the incidence of orofacial clefts in this hospital was 0.76/1000 births/year. Incidence in boys was 0.71/1000 births and in girls it was 0.78/1000 births (p < 0.7). Distribution of CL ± P showed that cleft lip with palate were more prevalent, which was 64.4%. 54.2% of the female child had clefts. Pierre-Robin syndrome was the most common associated malformation.ConclusionThis study indicates that CL ± P are the most common types of orofacial clefts. Adequate ante-natal history in birth records is not been given critical importance, with lack of parental counseling. Public awareness regarding the early diagnosis of orofacial clefts, follow up, surgery and dental therapy is required.How to cite this article: Kumar PSP, Dhull KS, Lakshmikantha G, Singh N, Incidence and Demographic Patterns of Orofacial Clefts in Mysuru, Karnataka, India: A Hospital-based Study. Int J Clin Pediatr Dent, 2018;11(5):371-374.

Burden of Orofacial Clefting in India, 2016: A Global Burden of Disease Approach.

Background:In the recent past, there have been inconsistent reports of India witnessing a decreasing trend in the incidence of orofacial clefts (OFC). To date, little comprehensive evidence has been published. To identify the prevalence, associated burden in terms of epidemiological parameters and to estimate the “unmet” OFC treatment needs, the present study was undertaken.Materials and Methods:Using the Global Burden of Diseases 2016 approach and its assumptions, an attempt was made to estimate the prevalence to quantify the burden of OFC in India as disability-adjusted life years (DALYs), years of life lost (YLL), and years lived with disability (YLD) as well as death due to OFC. The results from such an approach are presented. Using previous estimates of “unmet” OFC treatment needs, an attempt was made to estimate the current volume of “unmet” OFC treatment needs.Results:In the present study, it was estimated that a total of 0.033% of all Indian population suffers from OFC. In 2016, the estimated prevalence rate/100,000 was 33.27 for males, 31.01 for females, and 32.18 combined for both genders. It was estimated that for all ages, the DALYs lost were 2.05 for 100,000 males, 2.66 for females and 2.34 for both sexes. The OFC birth prevalence model revealed that the birth prevalence (as a proportion) in 2016 in India showed an odds ratio of 0.48 (1.56–1.65) and fixed factor of nonrecording 0.83 (0.15–6.63), underreporting 0.97 (0.88–1), gender 1.09 (1.02–1.16), chromosomal diagnoses included 1.22 (1.22–1.22), and stillbirth 1.22 (1.22–1.22). The total unmet cleft treatment need was estimated at 79,430 or 18.76% of the total Indian cleft population with OFC.Conclusions:Within the constraints of the mathematical modeling and based on all available surveys, literature, and reported data, the overall birth prevalence and the prevalence of OFC in India are presented. Till reliable data emerges, the present estimates could serve as a robust estimate of the prevalence and burden of OFC in India. The present enterprise highlights the need for well-designed, high-quality Pan-India, community-based, observational studies to accurately estimate the burden of OFC in India.

Role of MSX1 Gene in Orofacial Clefting : A Systematic Review

Introduction Orofacial clefting has always been the bane of the human race. It affects the overall wellbeing of the affected individual both phycological as well as physical. The Incidence of orofacial clefts have been around 1:500.4 Orofacial clefts can occur from an isolated cleft palate to a

Descriptive Epidemiology of Orofacial Clefts in Ethiopia.

The prevalence of birth defects including orofacial clefts (OFC) in Ethiopia is not known and there is no established birth defects registration system. To investigate the prevalence and incidence of OFC in Ethiopia. Retrospective hospital-based descriptive study. The authors obtained data from the Smile Train database on Ethiopian patients with OFC who underwent surgical treatment from June 2007 to December 2013 at 31 hospitals distributed throughout the country. Data related to live births in Ethiopia during the mentioned period were obtained from the Federal Ministry of Health database for estimates of the incidence and prevalence rates. The total number of life births during the study period was 18,811,316. During this same period, 18,073 cleft patients approximately ranging from 1 to 75 years old were examined and treated at the hospitals mentioned earlier. The incidence rate estimated from the total number of affected children during the study period (N = 8232) is 0.44/1000 live births. The prevalence rate is 0.20/1000 and this was estimated using the number of total population in 2013 (N = 88,703,914). There is a significant difference in frequency between bilateral clefts of the lip and/or palate (CLP) (26.9%) versus unilateral CLP (73.1%) (P < 0.0001). There is also a significant difference in frequency between bilateral cleft lips only (15.4%) versus unilateral cleft lip only (84.6%), P < 0001. It is obvious that the findings in this study cannot be representative of the true picture but provides a previously unavailable national estimate of incidence and prevalence of OFC in Ethiopia. It can also be used as comparison for future community-based studies.

Maternal exposure to ozone and PM2.5 and the prevalence of orofacial clefts in four U.S. states

BackgroundWhile there is some evidence that maternal exposure to ambient air pollution is associated with orofacial clefts in offspring, the epidemiologic studies have been largely equivocal. We evaluated whether maternal exposure to elevated county-level ambient fine particulate matter with aerodynamic diameter ≤2.5µm (PM2.5) and ozone during early gestation was associated with a higher prevalence of orofacial clefts. MethodsBirth data consisting of 4.7 million births from 2001 to 2007 were obtained from National Birth Defects Prevention Network for four states — Arizona, Florida, New York (excluding New York City), and Texas. The air pollution exposure assessment for gestational weeks 5–10 was based on county-level average concentrations of PM2.5 and ozone data generated using a Bayesian fusion model available through CDC's Environmental Public Health Tracking Network. Two outcomes were analyzed separately: cleft lip with or without cleft palate, cleft palate alone. In logistic regression analyses, we adjusted for factors that were suspected confounders or modifiers of the association between the prevalence of orofacial clefts and air pollution, i.e., infant sex, race-ethnicity, maternal education, smoking status during pregnancy, whether this was mother's first baby, maternal age. ResultsEach 10µg/m3 increase in PM2.5 concentration was significantly associated with cleft palate alone (OR =1.43, 95% CI: 1.11–1.86). There was no significant association between PM2.5 concentration and cleft lip with or without cleft palate. No associations were observed between ozone exposure and the two outcomes of orofacial clefts. ConclusionsOur study suggests that PM2.5 significantly increased the risk of cleft palate alone, but did not change the incidence of cleft lip with or without palate. Ozone levels did not correlate with incidence of orofacial clefts.

Cleft lip and palate.

1. Mary-Alice Abbott, MD, PhD* 1. *Department of Pediatrics, Division of Medical Genetics, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA. Editor’s Note: In the recently published article “Causal Attributions of Cleft Lip and Palate Across Cultures” (Cleft Palate Craniofac J. 2013;50[6]:655–661), the authors state that, across the world, culturally held beliefs concerning cleft lip and palate can have deleterious social effects on children and their families. Our readers should keep this in mind as they read the following article. Joseph A. Zenel, MD Editor-in-Chief Physicians should be aware of the potential associated medical problems with orofacial clefts, including airway obstruction, feeding difficulties, speech and language abnormalities, otitis media, and underlying genetic syndromes. After completing this article, readers should be able to: 1. Understand the role of genetics and environmental factors in the incidence of orofacial clefts. 2. Be aware of the availability of special nipples and bottles for feeding some infants with orofacial clefts. 3. Recognize the associations between cleft palate and airway issues (Pierre Robin sequence) and palatal dysfunction and otitis media. Oral-facial clefts are a common birth defect, occurring in approximately 1 in 600 US live births. (1) Epidemiologic studies have found that incidence varies according to sex and ethnic background; clefts occur most commonly in Native American and Asian populations and are least common in those with African heritage. Clefts of the lip are associated with a palatal cleft in approximately two-thirds of affected individuals. Cleft lip with or without cleft palate occurs more often in males, whereas isolated cleft palate is seen more often in females; cleft lip with or without cleft palate is more frequent that cleft palate alone. Facial development is a complex process. Five structures are involved in the development of the fetal face: the median frontonasal prominence, …

Incidence of Orofacial Clefts in Kumasi, Ghana

Background. Cleft lip and cleft palate are among the most common orofacial congenital anomalies. This study is to establish Orofacial Clefts Database for Kumasi, Ghana, with a view to extend it to other cities in future to obtain a national orofacial anomaly database. Methods. A descriptive prospective survey was carried out at eleven selected health facilities in Kumasi. Results. The total number of live births recorded was 27,449. Orofacial anomalies recorded were 36, giving an incidence of 1.31/1000 live births or 1 in 763 live births. The mean maternal age of cleft lip/palate babies was 29.85 years (range 18–40 years). The male : female ratio for the orofacial anomalies babies was 1.3 : 1; the male : female ratio was 0.5 : 1 in the cleft lip group, 1.3 : 1 in the cleft lip and palate group, and 4 : 1 in the cleft palate group. The majority of clefts were unilateral (69.4%, n=25), with females (n=14) outnumbering males (n=11). A family history of cleft was recorded with five babies (13.9%). Associated congenital anomalies were recorded in seven (19.4%) cleft lips and/or palates. Conclusion. The incidence of 1 in 763 live births found in this study indicates that cleft lip/palate is a common congenital anomaly in Kumasi.

Incidence of cleft lip and palate in the occupied Palestinian territory: a retrospective study

<h3>Background</h3> Orofacial clefts are the most common craniofacial anomaly in newborn babies. The incidence varies in different ethnic populations and is presumed to be highest in developing countries. In the Middle East, the reported incidence per 1000 livebirths per year was from 0·3 to 2·19 per year and is generally thought to be similar to rates reported in white populations. In Israel and Jordan, the incidence is recorded as 1·39 per 1000 livebirths per year. The incidence of oral clefts in Palestinians living in the occupied Palestinian territory (oPt) has not been reported so far and might not be similar to that in stable populations. We therefore investigated the incidence of these anomalies in the oPt. <h3>Methods</h3> We inspected the records of all newborn babies delivered at the Makassed Maternity Hospital, East Jerusalem, oPt, between Jan 1, 1986, and Dec 12, 1995. The catchment area of the hospital included people residing inside and outside East Jerusalem. Data were gathered by AD and interpreted by the other investigators. Incidences were reported as the number of newborn babies with orofacial clefts per 1000 livebirths per year. <h3>Findings</h3> Between Jan 1, 1986, and Dec 12, 1995, 33 239 livebirths were recorded at the hospital. 35 infants had orofacial clefts, yielding an incidence of 1·05 per 1000 livebirths per year: six infants (0·18 per 1000 livebirths) had isolated cleft lip, 14 (0·421 per 1000 livebirths) cleft lip and palate, five had other anomalies, and ten had other non-specified orofacial clefts. <h3>Interpretation</h3> On the basis of this small dataset from one tertiary referral hospital, we conclude that the incidence of orofacial clefts in Palestinians living in the oPt is similar to that reported in neighbouring countries. However, these results need to be confirmed in large broad studies with data from the national birth registries. <h3>Funding</h3> None.

Modulation of Diabetes‐Induced Palate Defects by Maternal Immune Stimulation

Maternal diabetes can induce a number of developmental abnormalities in both laboratory animals and humans, including deformities of the face and palate. The incidence of birth defects in newborns of women with diabetes is approximately 3 to 5 times higher than among nondiabetics. In mice, nonspecific activation of the maternal immune system can reduce fetal abnormalities caused by various etiologies including hyperglycemia. This study was conducted to determine whether nonspecific maternal immune stimulation could reduce diabetes-induced palate defects and orofacial clefts. Female ICR mice were immune stimulated before induction of hyperglycemia with Freund's complete adjuvant (FCA), granulocyte-macrophage colony-stimulating factor (GM-CSF), or interferon-gamma (IFNgamma). Streptozocin was used to induce hyperglycemia (26-35 mmol blood glucose) in females before breeding. Fetuses from 12 to 18 litters per treatment group were collected on Day 17 of gestation. Palate width and length were measured, and the incidence of orofacial clefts was determined. Palate length and width were both decreased by maternal hyperglycemia. Maternal immune stimulation with GM-CSF or FCA limited the degree of palate shortening from the hyperglycemia. Each of the three immune stimulants attenuated significant narrowing of the palate. Rates of orofacial clefts were not significantly different between treatment groups. Palatogenesis is a complex process driven by cellular signals, which regulate cell growth and apoptosis. Dysregulation of cellular signals by maternal hyperglycemia can result in fetal malformations. Maternal immune stimulation may prevent dysregulation of these signaling pathways thus reducing fetal malformations and normalizing palate growth.

Incidence of Orofacial Clefts in the Slovak Republic

Orofacial clefts (OC) are quite common congenital defects. Retrospective active survey collecting clinical data of children with OC examined and operated on in the three main specialized departments of plastic surgery in the Slovak Republic over 16 years (1985-2000) revealed total incidence of 1.61/10(3) live births (LB). 1,849 children suffering from OC were recognised out of 1,147,236 live births. Total incidence (TI) of OC per 1,000 live births was determined by types, gender, regions, districts and seasonal variation. The highest rate, 40.5% of clefts, affected the primary and secondary palate (CLP), more than 32% were of cleft palate type (CP), about 26% cleft lip (CL) and about 1% of associated malformations (AM). Clefts in males (1.71/10(3) LB) were significantly more common than in females (1.50/10(3) LB), sex ratio 1.14:1. Morbidity rates (TI) varies from 1.29/10(3) LB in the east Slovakia to the highest incidence of 1.93/10(3) LB in the middle Slovakia with wide range by district. Comparing data from the study and from the national register, 17% of children with OC were missed. Presented survey assessed risk of OC in Slovakia at the rate 1 newborn with OC per 620 LB compared with notified frequency of 1 OC per 745 LB.

O.375 Incidence of orofacial clefts in Kosova during and after the war

O.375 Incidence of orofacial clefts in Kosova during and after the war

An epidemiological study of orofacial clefts in Croatia 1988–1998

The objective of this epidemiological study was to assess the incidence at birth of orofacial clefts in Croatia. The aim of the present study was to analyse the character and incidence of orofacial clefts in Croatia and to compare the data with reports from other countries. All the material for the epidemiological study was retrieved from the documented files from all the neonatal units and hospitals in Croatia providing surgical treatment. A total of 525,298 livebirths were documented during 11 years (1988-1998); 903 among them with orofacial clefts, 24 (2.7%) of them twins. Sixty (6.6%) infants died between birth and the age of 6 months. The incidence of orofacial clefts during the study period was 1.71 per thousand. When eliminating syndromic clefts, the incidence of non-syndromic clefts was 1.56 per thousand. Analysis of cleft lip with or without cleft palate (CL+/-P) and isolated cleft palate only (CP) revealed their incidence to be 1.05 and 0.66 per 1000, respectively. Of all types of clefting, CL and CLA was found in 17.2%, CL+/-P in 43.9%, CP in 38.2% and atypical facial clefts (AFC) in 0.8% of children. Left-sided clefts were most common (51%), followed by bilateral (30.5%) and right-sided (18.5%) clefts. The male to female ratio was 1.3. CL+/-P predominated in male and CP in female children. In 220 cases (24.4%) orofacial clefts were either associated with other anomalies or the clefts occurred as one feature of a syndrome. Data obtained from different sources yielded a cleft incidence of 1.71 per 1000 in Croatia. There were no differences in the incidences of orofacial clefts in comparison with similar data from other European countries.

Incidencia de labio leporino y paladar hendido en la Maternidad del Hospital Clínico de la Universidad de Chile y en las maternidades chilenas participantes en el Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC) período 1991-1999

ECLAMC is a registry, aimed to assess the incidence of congenital malformations, that started in 1967 and Chile incorporated to it in 1969. To report the incidence of cleft lip/palate, updated to 1999 in the University of Chile Maternity Hospital and other Chilean hospitals participating in the ECLAMC. A review of the ECLAMC database that registers all births or stillbirths of more than 500 g. The incidence of orofacial cleft, at the University of Chile Maternity Hospital, in the period 1991-1999 was 17.8 per 10,000 (12.6 for cleft lip and 5.2 for cleft palate). The incidence in the rest of participating hospitals was 12.04 and 4.6 respectively. Males had a higher incidence of cleft lip and 80% of children with cleft palate, had other malformations, most of them as part of a syndrome (13 and 18 trisomy, holoproscencephalia, Pierre Robin, Apert en EE syndromes, anencephaly etc). In three of 12 children with cleft lip but without cleft palate, there was a relative with the same malformation. It is proposed that both entities, cleft lip with or without cleft palate and cleft palate without cleft lip, are two etiopathogenically different conditions.