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Decreasing prevalence of oral cleft live births in the Netherlands, 1997–2006
  1. Anna M Rozendaal1,2,
  2. Antonius JM Luijsterburg1,
  3. Edwin M Ongkosuwito2,3,
  4. Esther de Vries4,
  5. Christl Vermeij-Keers1,3
  1. 1Research Unit Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  2. 2Department of Orthodontics, Erasmus MC – Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
  3. 3Cleft Palate Team, Erasmus MC – Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Anna M Rozendaal, Research Unit Department of Plastic and Reconstructive Surgery, Room 1591, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands; am.rozendaal{at}gmail.com

Abstract

Objectives The number of new oral cleft patients has fallen in the Netherlands. This may be explained by two hypotheses: (1) greater prenatal detection of congenital anomalies has led to more pregnancy terminations and (2) increased folic acid use has reduced the oral cleft risk. Both hypotheses would mainly apply to the category cleft lip/alveolus ± cleft palate (CL±P), since, unlike cleft palate only (CP), CL±P can be detected prenatally by two-dimensional (2D) ultrasound and develops during the period recommended for folic acid use. The authors aimed to determine trends in prevalence over 1997–2006 and to evaluate the hypotheses by stratifying trends by cleft category.

Methods This study was a time–trend analysis of infants born alive with oral clefts in the Netherlands during 1997–2006 and registered in the national oral cleft registry. The authors calculated prevalence rates and the estimated annual percentage change (EAPC) for all oral clefts and the two categories.

Results In 1997–2006, 3308 infants out of 1 970 872 live births had oral clefts, an overall prevalence per 10 000 live births of 16.8 (CL±P: 11.3; CP: 5.5). Time–trend analysis showed that the prevalence of all oral clefts decreased (EAPC −1.8%; 95% CI: –3.0% to −0.6%), as did the CL±P prevalence (EAPC −2.3%; 95% CI: −3.8% to −0.9%). No significant trends were found for the CP prevalence.

Conclusions Because the live-birth prevalence of CL±P decreased, that of all oral clefts decreased. These findings are in line with both hypotheses and may therefore have implications for prenatal counselling and folic acid policy.

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Footnotes

  • Competing interests None.

  • Ethical approval Studies of anonymous data from health registries do not require ethical approval in the Netherlands, and the principles outlined in the Declaration of Helsinki were followed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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