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Orofacial clefts in the National Birth Defects Prevention Study, 1997–2004
Author(s) -
Genisca Alicia E.,
Frías Jaime L.,
Broussard Cheryl S.,
Honein Margaret A.,
Lammer Edward J.,
Moore Cynthia A.,
Shaw Gary M.,
Murray Jeffrey C.,
Yang Wei,
Rasmussen Sonja A.
Publication year - 2009
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.32854
Subject(s) - holoprosencephaly , medicine , craniofacial , population , pediatrics , pregnancy , fetus , genetics , biology , environmental health , psychiatry
Orofacial clefts are among the most common types of birth defects, but their clinical presentation has not been well described in a geographically diverse US population. To describe the birth prevalence and phenotype of nonsyndromic clefts, we used data from the National Birth Defects Prevention Study (NBDPS), a multi‐site, population‐based, case‐control study aimed at identifying genetic and environmental risk factors for birth defects. Included in the study were infants born during 1997–2004 with a cleft lip (CL), cleft lip with cleft palate (CLP), or cleft palate (CP). Infants with clefts associated with recognized single‐gene disorders, chromosome abnormalities, holoprosencephaly, or amniotic band sequence were excluded. A total of 3,344 infants with nonsyndromic orofacial clefts were identified, including 751 with CL, 1,399 with CLP, and 1,194 with CP, giving birth prevalence estimates of 0.3, 0.5, and 0.4/1,000 live births, respectively. Among infants with CLP where cleft laterality was specified, about twice as many had unilateral vs. bilateral involvement, while for CL there were over 10 times as many with unilateral versus bilateral involvement. Involvement was most often left‐sided. About one‐quarter of infants with CP had Pierre Robin sequence. Over 80% of infants had an isolated orofacial cleft. Among infants with CL or CLP, heart, limb, and other musculoskeletal defects were most commonly observed, while heart, limb, and central nervous system defects were most common among infants with CP. Better understanding of the birth prevalence and phenotype may help guide clinical care as well as contribute to an improved understanding of pathogenesis. Published 2009 Wiley‐Liss, Inc.