To provide the prevalence and an overview of cleft lip and palate (CL/P) in the period of 2008 to 2017, as well as the profile of care provided for this condition in Brazil.
Design
Cross-sectional study of epidemiological character.
Setting
Brazilian government website.
Participants
National Live Birth and Hospital Information System.
Intervention
Organization of the end databases and performance-based statistical analysis.
Main Outcome Measure(s)
Analysis of the prevalence of CL/P in newborns, sociodemographic condition of the mothers, surgical procedures and hospitalizations, and specialized hospitals in Brazil within a 10-year period.
Results
The average prevalence of CL/P in Brazil was ∼52 children per 100 000 live births in the covered period, corresponding to 1 per 1924 newborns. The presence of cleft was associated with preterm birth, being underweight, and the male gender. The highest prevalence was found in the South region, while the lowest was found in the Northeast region, with increasing rates in the North region of Brazil. The states with the highest prevalence were not those with a great number of hospitalizations and surgical procedures for live births with CL/P.
Conclusion
In the 10-year study period, the prevalence of CL/P was 0.52 newborns per 1000 live births, a result which differs among the states of Brazil. The need to reinforce the national monitoring of the prevalence and surgical procedures of cleft patients have also emphasized the need to improve public medical care for CL/P subjects.
AbreuMHLeeKHLuquetti DVStarrJR. Temporal trend in the reported birth prevalence of cleft lip and/or cleft palate in Brazil, 2000 to 2013. Birth Defects Res A Clin Mol Teratol. 2016;106(9):789-792.
2.
AlbuquerqueMVVianaALDLimaLDFerreiraMPFusaroERIozziFL. Regional health inequalities: changes observed in Brazil from 2000–2016. Cien Saude Colet. 2017;22(4):1055-1064.
3.
AljohaniMYatesJAshleyMO’MalleyL. Evaluation of quality of life in adult individuals With cleft lip and/or palate. J Craniofac Surg. 2021;32(2):505-508
4.
Angulo-CastroEAcosta-AlfaroLFGuadron-LlanosAMCanizalez-RomanAGonzalez-IbarraFOsuna-RamirezIMurillo-LlanesJ. Maternal risk factors associated with the development of cleft lip and cleft palate in Mexico: a case-control study. Iran J Otorhinolaryngol. 2017;29(93):189-195.
5.
BehagueDPVictoraCGBarrosFC. Consumer demand for caesarean sections in Brazil: informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods. Br Med J. 2002;324(7343):942-945.
6.
ButtsSCReynoldsSGitmanLPatelPJosephM. Patterns of orofacial clefting in New York City from 1983 to 2010: trends by racial background, birthplace, and public health strategies. Cleft Palate Craniofac J. 2018;55(9):1191-1199.
7.
CandottoVObertiLGabrioneFGrecoGRossiDRomanoMMummoloS. Current concepts on cleft lip and palate etiology. J Biol Regul Homeost Agents. 2019;33(3 Suppl. 1):145-151.
8.
CostaCMda GamaSGLealMC. Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors. Cad Saude Publica. 2006;22(11):2423-2431.
9.
CroenLAShawGMWassermanCRTolarovaMM. Racial and ethnic variations in the prevalence of orofacial clefts in California, 1983–1992. Am J Med Genet. 1998;79(1):42-47.
10.
De CuyperEDochyFDe LeenheerEVan HoeckeH. The impact of cleft lip and/or palate on parental quality of life: a pilot study. Int J Pediatr Otorhinolaryngol. 2019;126:109598.
11.
DiazMD. Socio-economic health inequalities in Brazil: gender and age effects. Health Econ. 2002;11:141-154.
12.
DienVHAMcKinneyCMPisekAPitiphatW. Maternal exposures and risk of oral clefts in south Vietnam. Birth Defects Research. 2018:110(6):527-537.
13.
DixonMJMarazitaMLBeatyTHMurrayJC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011;12(3):167-178.
14.
DominguesRMSMDiasMABNakamura-PereiraMTorresJAD’OrsiEPereiraAPELealMDC. Process of decision-making regarding the mode of birth in Brazil: from the initial preference of women to the final mode of birth. Cad Saude Publica. 2014;30:S1-S16.
15.
do Rego BorgesASaJHoshiRVienaCSMarianoLCde CastroVPReisSR. Genetic risk factors for nonsyndromic cleft lip with or without cleft palate in a Brazilian population with high African ancestry. Am J Med Genet. 2015;167A(10):2344-2349.
16.
FreitasJADalbenGSSantamariaMJrFreitasPZ. Current data on the characterization of oral clefts in Brazil. Braz Oral Res. 2004;18(2):128-133.
17.
Gil-da-Silva-LopesVLMonlleoIL. Risk factors and the prevention of oral clefts. Braz Oral Res. 2014;28 Spec:1-5.
18.
HagbergCLarsonOMileradJ. Incidence of cleft lip and palate and risks of additional malformations. Cleft Palate Craniofac J. 1998;35(1):40-45.
19.
Hardin-JonesMAJonesDL. Speech production of preschoolers with cleft palate. Cleft Palate Craniofac J. 2005;42(1):7-13.
20.
Landmann-SzwarcwaldCMacinkoJ. A panorama of health inequalities in Brazil. Int J Equity Health. 2016;15(174):1-3.
21.
LiaoYFMarsM. Long-term effects of clefts on craniofacial morphology in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2005;42(6):601-609.
22.
MaLHouYLiuGZhangT. Effectiveness of presurgical orthodontics in cleft lip and palate patients with alveolar bone grafting: a systematic review. J Oral Maxillofac Surg. 2021;122(1):13-17.
23.
MangoldELudwigKUBirnbaumSBaluardoCFerrianMHermsSNothenMM. Genome-wide association study identifies two susceptibility loci for nonsyndromic cleft lip with or without cleft palate. Nat Genet. 2010;42(1):24-26.
24.
MaranhaoSCSaJCangussuMCTColettaRDReisSRAMedradoA. Nonsyndromic oral clefts and associated risk factors in the state of Bahia, Brazil. Eur J Paediatr Dent. 2021;22(2):121-127.
25.
MartelliDRBCruzKWBarrosLMSilveiraMFSwertsMSOJúniorHM. Maternal and paternal age, birth order and interpregnancy interval evaluation for cleft lip/palate. Braz J Otorhinolaryngol. 2010;76(1):107-112.
26.
McLeodNMUriosteMLSaeedNR. Birth prevalence of cleft lip and palate in Sucre, Bolivia. Cleft Palate Craniofac J. 2004;41(2):195-198.
27.
MosseyPACastilliaE. Global registry and database on craniofacial anomalies. Geneva: World Health Organization (WHO). 2003.
28.
MosseyPALittleJMungerRGDixonMJShawWC. Cleft lip and palate. Lancet. 2009;374(9703):1773-1785.
29.
MosseyPAModellB. Epidemiology of oral clefts 2012: an international perspective. Front Oral Biol. 2012;16:1-18.
30.
RavichandranKShoukriMAljoharAShaziaNSAl-TwaijriYAl JarbaI. Consanguinity and occurrence of cleft lip/palate: a hospital-based registry study in Riyadh. Am J Med Genet. 2012;158A(3):541-546.
31.
RochaRAtunRMassudaARacheBSpinolaPNunesLLagoMCastroMC. Effect of socioeconomic inequalities and vulnerabilities on health-system preparedness and response to COVID-19 in Brazil: a comprehensive analysis. Lancet Glob Health. 2021;9(6):e782-e792.
32.
ShibukawaBMCRissiGPHigarashiIHOliveiraRR. Factors associated with the presence of cleft lip and/or cleft palate in Brazilian newborns. Rev Bras Saude Mat Infant. 2019;19(4):947-956.
33.
SilvaHArrudaTTSSouzaKSCBezerraJFLeiteGCPBritoMEFRezendeAA. Risk factors and comorbidities in Brazilian patients with orofacial clefts. Braz Oral Res. 2018;32:e24.
34.
SilveiraMFSantosISBarrosAJMatijasevichABarrosFCVictoraCG. Increase in preterm births in Brazil: review of population-based studies. Rev Saude Public. 2008:42(5):957-964.
35.
SmariusBLoozenCMantenWBekkerMPistoriusLBreugemC. Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology. World J Methodo. 2017;7(3):93-100.
36.
SousaGFRoncalliAG. Orofacial clefts in Brazil and surgical rehabilitation under the Brazilian national health system. Braz Oral Res. 2017;31:e23.
37.
SouzaAMResendeSSSousaTNBritoCFA. A systematic scoping review of the genetic ancestry of the Brazilian population. Genet Mol Biol. 2019;42(3):495-508.
38.
SzwarcwaldCLSouza JuniorPRMarquesAPAlmeidaWDMontillaDE. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the national health survey, 2013. Int J Equity Health. 2016;15:141.
39.
TanakaSAMahabirRCJupiterDCMenezesJM. Updating the epidemiology of cleft lip with or without cleft palate. Plast Reconstr Surg. 2012;129(3):511e-518e.
40.
VyasTGuptaPKumarSGuptaRGuptaTSinghHP. Cleft of lip and palate: a review. J Family Med Prim Care. 2020;9(6):2621-2625.
41.
WebbAAWattsRRead-WardEHodgkinsJ, Markus AF. Audit of a multidisciplinary approach to the care of children with unilateral and bilateral cleft lip and palate. Br J Oral Maxillofac Surg. 2001;39(3):182-188.
42.
WHO (World Health Organization). Global strategies to reduce the health care burden of craniofacial anomalies: report of WHO meetings on international collaborative research on craniofacial anomalies. Cleft Palate Craniofac J. 2004;41(3):238-243.
43.
WoodSLTangSCrawfordS. Cesarean delivery in the second stage of labor and the risk of subsequent premature birth. Am J Obstet Gynecol. 2017;217(1):e61–63-e10.
44.
WyszynskiDFSarkoziAVarghaPCzeizelAE. Birth weight and gestational age of newborns with cleft lip with or without cleft palate and with isolated cleft palate. J Clin Pediatr Dent. 2003;27(2):185-190.
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