BACKGROUND: An increased prevalence of cleft lip and/or palate (CL/P), a major congenital anomaly, has been observed in the offspring of women with elevated body mass index (BMI) before pregnancy. Likewise, gestational comorbidities, such as hypertension and diabetes mellitus, also increase the risk of CL/P; however, the risk linked to the coexistence of these conditions in women with higher BMI on birth prevalence of CL/P remains unclear. This study focused on the combined effects of a high BMI before pregnancy and gestational comorbidities on the birth prevalence of CL/P. METHODS: Among 98,373 live births from the Japan Environment and Children's Study (JECS), a nationwide birth cohort, 255 mothers of infants with CL/P (74, 112, and 69 infants born with cleft lip, cleft lip and palate, and isolated cleft palate, respectively) were included in the analyses. The association of CL/P birth prevalence with pre-pregnancy BMI and gestational comorbidities (hypertension and diabetes) was examined using multivariate logistic regression analyses after multiple imputations, with adjustments for several maternal (age at delivery, smoking habits, and alcohol intake) and child-related (sex and prevalence of other congenital diseases) variables, obtained through medical record transcriptions and self-reports on JECS transcription forms. RESULTS: Higher prevalence rates of overweight, gestational hypertension, and gestational diabetes mellitus were found in mothers of infants with CL/P (16.1%, 6.3%, and 4.7%, respectively) than in the control group (10.4%, 3.1%, and 3.1%, respectively). The odds ratio [95% confidence interval] for childbirth with CL/P was increased in mothers with high BMI before pregnancy (1.58 [1.11-2.24]). Furthermore, gestational hypertension and diabetes coexisting with high BMI additionally increased the odds ratios for childbirth with CL/P (2.91 [1.28-6.61] and 2.12 [0.87-5.19], respectively). CONCLUSION High maternal BMI, particularly when accompanied by gestational hypertension, was significantly associated with an increased prevalence of childbirth with CL/P.
Humans ; Female ; Cleft Lip/etiology* ; Cleft Palate/etiology* ; Pregnancy ; Japan/epidemiology* ; Prevalence ; Body Mass Index ; Adult ; Male ; Infant, Newborn ; Comorbidity ; Diabetes, Gestational/epidemiology* ; Risk Factors ; Young Adult ; Birth Cohort

Objective To investigate the multiple correspondence of genetic and environmental risk factors with abnormal birth history and provide a scientific basis for improving the birth defects surveillance system and reducing the incidence of birth defects. Methods Data were collected from all the perinatal infants from 28-week-old fetuses to 7-day-old infants born in all the hospitals with obstetrical department in Xi'an from 2003 to 2015. Results A total of 1 236 937 perinatal infants were surveyed,including 10 619 with birth defects.The average incidence rate of birth defects was 0.86% (0.70%-1.15%).Multiple correspondence analysis showed that the women who had had 1 or 2 children with birth defects were associated with the history of spontaneous abortion,family history of birth defects,and history of exposure to toxic and harmful substances.The women who had had 3 or more children with birth defects showed stronger association with family history of birth defects.The birth defects in women with history of spontaneous abortion (257/10 619) was ranked in the order of congenital heart disease,polydactyly,neural tube defects,congenital hydrocephalus,cleft lip with cleft palate,and simple cleft lip.The birth defects in women who had given birth to children with birth defects (135/10 619) followed the order of cleft lip with cleft palate,anencephaly,hydrocephalus,neural tube defects,cleft lip,and talipes equinovarus. Conclusions Abnormal birth history is associated with family history of birth defects and history of exposure to environmental risk factors.Giving birth to three or more children with birth defects is highly correlated with the family history of birth defects.
Child ; Pregnancy ; Female ; Humans ; Cleft Lip/etiology* ; Cleft Palate/complications* ; Reproductive History ; Abortion, Spontaneous ; Neural Tube Defects/epidemiology* ; Risk Factors

OBJECTIVETo investigate the association between non-syndromic cleft lip with or without cleft palate (NSCL/P) and environmental factors in Ningxia population.

METHODSThis case-control study involved 453 NSCL/P patients and 452 normal newborns from Ningxia. A questionnaire focusing on various factors, including family history, pregnancy reaction, drug use during pregnancy, and infections, was used and responses were analyzed through Chi-square test and Logistic regression analysis with SPSS 16.0.

RESULTSThe constituent ratio of different types of NSCL/P was cleft lip∶cleft lip and palate∶cleft palate equal to 1︰2.02︰1.51. Logistic regression analysis revealed that abnormal pregnancy, infection, abortion, drugs, drinking, smoking, and living near factories likely increased the risk of NSCL/P (P<0.05). Single fetus, pregnancy-related nausea, vomiting, parents' moderate tastes, and eating soy foods and fruits decreased the risk of NSCL/P (P<0.05).

CONCLUSIONSThe incidence of NSCL/P should be reduced to enhance the conditions of women during pregnancy by maintaining a balanced diet and avoiding infections, abortion, drugs, and negative habits. 
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Case-Control Studies ; China ; epidemiology ; Cleft Lip ; epidemiology ; Cleft Palate ; epidemiology ; Diet ; Female ; Humans ; Incidence ; Infant, Newborn ; Parents ; Pregnancy ; Smoking

OBJECTIVETo investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention.

METHODSA total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed.

RESULTSThe effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (P<0.05). The SSRS scores of patients with anxiety disorder were lower than those of patients without anxiety disorder (P<0.05). Multiple regression analysis showed that gender and social support were predictive factors of the occurrence of anxiety disorder (R=0.318).

CONCLUSIONA high anxiety disorder rate occurred in adolescent patients with cleft lip and palate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

Adolescent ; Anxiety ; Anxiety Disorders ; epidemiology ; Child ; Cleft Lip ; epidemiology ; psychology ; Cleft Palate ; epidemiology ; psychology ; Humans ; Mental Health ; Parents ; Social Support ; Surveys and Questionnaires

In this study, we sought to determine the association between environmental factors and nonsyndromic cleft of the lip and/or palate (NSCLP) to understand the etiology of the disease. A total of 200 NSCLP cases and 327 controls were recruited at the Maternal and Child Health Hospital of Xuzhou City. We conducted face-to-face interviews with the mothers of both cases and controls. The factors increasing the risk of NSCLP were a positive family history [odds ratio (OR)=56.74], pesticide exposure (OR=8.90), and indoor decoration pollution (OR=4.32). On the other hand, the factors decreasing the risk of NSCLP were a high education level (OR=0.22) and supplementation of folic acid (OR=0.23) and multivitamins (OR=0.16). Positive family history, pesticide exposure, and indoor decoration pollution are associated with the risk of NSCLP. In contrast, high education level and folic acid and multivitamin supplementation are protective factors against NSCLP.
Case-Control Studies ; China ; epidemiology ; Cleft Lip ; epidemiology ; etiology ; prevention & control ; Cleft Palate ; epidemiology ; etiology ; prevention & control ; Environmental Pollutants ; toxicity ; Female ; Folic Acid ; administration & dosage ; therapeutic use ; Humans ; Infant, Newborn ; Logistic Models ; Maternal Exposure ; adverse effects ; Pregnancy ; Risk Factors ; Socioeconomic Factors ; Surveys and Questionnaires

NSCL/P is a common congenital defect and gene-environmental factors involve in this disorder. Periconceptional intake of folate may reduce the risk of NSCL/P. The present study investigated three SNPs (rs1801198, rs955516, and rs3733890) in three folate pathway genes, including TCN2, MTR, and BHMT among 481 patients and 558 healthy subjects. Rs955516 showed allelic association with NSCL/P. More patients carry rs955516 AA and rs3733890 AA genotypes. The gene-gene interaction test showed trans-phase combination effects for MTR and BHMT genes. Our study suggests that the interaction of MTR and BHMT genes play a vital role in the pathogenesis of NSCL/P in Chinese population.
Adolescent ; Adult ; Brain ; abnormalities ; Child ; Child, Preschool ; China ; epidemiology ; Cleft Lip ; epidemiology ; genetics ; Cleft Palate ; epidemiology ; genetics ; Female ; Folic Acid ; metabolism ; Genotype ; Humans ; Infant ; Male ; Polymorphism, Single Nucleotide ; Young Adult

OBJECTIVETo explore evaluation strategies for middle ear dysfunction in cleft palate patients, to optimize the diagnosis and treatment of this dysfunction, and ultimately to improve the comprehensive treatment of cleft palate.

METHODSThe relationship among abnormal tympanic types (B, C, and Anomaly), effusion rate, tympanic pressure, and hearing loss were analyzed. We collected relevant information on 469 ears of cleft palate patients and traced one-year longitudinal changes in the tympana of 124 ears from 62 patients with both cleft lip and cleft palate.

RESULTSThe effusion rates of cleft palate patients with type B, type C, and type Anomaly were 50.3% (97/193), 34.8% (8/23), and 20.9% (53/253), respectively. The tympanic pressure of the ears with and without effusion showed no significant difference (P>0.05). The hearing loss in type B cleft palate patients with middle ear effusion was worse than that in patients without effusion (P=0.001). However, the hearing loss in type Anomaly showed no difference (P>0.05). The constituent ratio of each tympanic type remained constant during the period between cheiloplasty and palatoplasty for cleft lip and palate patients (P>0.05).

CONCLUSIONCleft palate patients of all tympanic types may all suffer from middle ear effusion at different rates. Examination by centesis is suggested for ears with abnormal tympanic types. Early aggressive therapy is essential for type B cleft palate patients with middle ear effusion to avoid hearing loss. However, catheterization may be not necessary for type Anomaly patients, and conservative observation should be performed instead. Myringotomy with grommet insertion during palatoplasty does not delay treatment timing for patients with both cleft lip and cleft palateg.

Cleft Lip ; Cleft Palate ; Ear, Middle ; physiology ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; diagnosis ; epidemiology

Cleft Palate ; surgery ; Humans ; Incidence ; Oral Fistula ; epidemiology ; etiology ; Palate ; surgery ; Postoperative Complications ; epidemiology ; Reconstructive Surgical Procedures ; adverse effects ; Statistics as Topic

BACKGROUND: The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. METHODS: Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. RESULTS: Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). CONCLUSIONS: An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.
Alveolar Process ; Alveoloplasty ; Bias (Epidemiology) ; Bone Transplantation ; Child ; Cleft Palate ; Depression ; Fistula ; Humans ; Lip ; Photogrammetry ; Tooth ; Transplants

We investigated the livebirths prevalence and occurrence pattern of birth defects in Korea. After the survey on birth defects was done in 2,348 medical institutions around the nation, the birth defect prevalence of livebirths in 2005-2006 was calculated. This study was based on the medical insurance claims database of the National Health Insurance Corporation. The number of livebirths in Korea was 883,184 from 2005-2006, and 25,335 cases of birth defects were notified to our study, equivalent to a prevalence of 286.9 per 10,000 livebirths. Anomalies of the circulatory system were the most common defects, accounting for 43.4% of birth defects with a prevalence of 124.5 per 10,000 livebirths. It was followed by the musculoskeletal system anomalies, the digestive system anomalies, and the urinary system anomalies. The five major birth defects based on the ranking of prevalence were atrial septal defect, ventricular septal defect, hydronephrosis, patent ductus arteriosus, and cleft lip/palate. Birth defects in livebirths were associated with a high proportion of low birthweight, prematurity, multiple births and advanced maternal age. The prevalence of birth defects in Korea is similar to or lower than those reported in developed countries. Our study suggests baseline data to explain the current status of birth defects and to establish a registry system of birth defects in Korea.
Adult ; Asian Continental Ancestry Group ; Cleft Lip/epidemiology ; Cleft Palate/epidemiology ; Congenital Abnormalities/*epidemiology ; Databases, Factual ; Ductus Arteriosus, Patent/epidemiology ; Female ; Gestational Age ; Heart Septal Defects, Atrial/epidemiology ; Heart Septal Defects, Ventricular/epidemiology ; Humans ; Hydronephrosis/epidemiology ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Live Birth ; Male ; Maternal Age ; Musculoskeletal Abnormalities/epidemiology ; Pregnancy ; Prevalence ; Republic of Korea/epidemiology