Portal de Periódicos da CAPES

Updating the Epidemiology of Isolated Cleft Palate

2013; Lippincott Williams & Wilkins; Volume: 131; Issue: 4 Linguagem: Inglês

10.1097/prs.0b013e3182827790

1529-4242

Shoichiro Tanaka, Raman C. Mahabir, Daniel C. Jupiter, John M. Menezes,

Urological Disorders and Treatments

Sir:FigureIn the 1970s, Habib stated that the incidence of isolated cleft palate in the general population was 0.4 per 1000 live births.1 Racial variation in the incidence of cleft palate (Japanese population incidence of 0.5 per 1000)1 was much less than that seen with cleft lip with or without cleft palate, and cleft palate occurred more frequently as a constituent of a syndrome than did cleft lip with or without cleft palate.2 The purpose of our study was to report the current prevalence and trends of cleft palate both nationally and internationally. The methods for this study followed those of our previous article and analyzed data for 2002 to 2006.3 There was a great deal of variability in U.S. state data (Table 1). U.S. data demonstrated increasing rates of cleft palate (slope = 3.946e-05, p = 0.018), with an average rate of 5.03 (95 percent confidence limits, 4.72, 5.36) (Fig. 1). Internationally, there was a similar variability in the data (Table 1). The rate of cleft palate was 4.50 (95 percent confidence limits, 4.40, 4.60) and did not change significantly over the 5-year period (slope = 6.695e-06, p = 0.50) (Fig. 2). Countries with the three highest and lowest rates were Finland (13.26), Malta (10.10), and Germany (9.89), and Costa Rica (2.35), South Africa (1.79), and Cuba (1.49), respectively (Table 1). The grouped continental data for cleft palate rates demonstrated rates of 4.83 for the Americas, 4.53 for Europe, and 3.97 for Asia.Fig. 1: U.S. annual data of prevalence of cleft palate for 2002 to 2006.Fig. 2: International data of prevalence of cleft palate for 2002 to 2006.Table 1: Rate per 10,000 Live Births of Isolated Cleft Palate within the United States and Internationally by Country for 2002 to 2006Our study found a wide range of cleft palate rates in the United States and around the world. Both national and international rates were slightly higher than previously reported rates. It is necessary to remember that these rates are derived from surveillance systems and do not represent a country's (or continent's) total population.3 This type of research is limited by the underestimation of the surveillance systems.4 Despite this, the data collected from the surveillance systems, while not accounting for each country in its entirety, still remain the best available estimate. Another limitation to this type of research is a general lack of uniform collection procedures.5 If the rates for cleft palate had been reported for live births only, it would allow for only one population to be utilized for comparisons among countries, as well as a practical understanding of the prevalence of cleft palate. While only looking at live births may underreport the actual prevalence of cleft palate, it is the specific population physicians identify and whom they can later treat. To discuss the causes of cleft palate was well beyond the scope of this article. Using what data were readily available, we were simply trying to discuss the prevalence of cleft palate at the national and international levels. In summary, the average prevalence of isolated cleft palate was 5.03 and 4.50 per 10,000 live births in the United States and internationally, respectively. There appeared to be a significant trend toward an increasing prevalence in the United States that was not seen internationally. Shoichiro A. Tanaka, B.S., M.P.H. Texas A & M Health Science Center College of Medicine, Temple, Texas Raman C. Mahabir, M.D., M.Sc. Texas A & M Health Science Center College of Medicine, Division of Plastic Surgery, Scott and White Healthcare, Temple, Texas Daniel C. Jupiter, Ph.D. Texas A & M Health Science Center College of Medicine, Department of Surgery, Scott and White Healthcare, Temple, Texas John M. Menezes, M.D. Division of Plastic Surgery, University of Nevada School of Medicine Las Vegas, Nev. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.