Harville Emily W, Wilcox Allen J, Lie Rolv Terje, Abyholm Frank, Vindenes Hallvard
Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
Eur J Epidemiol. 2007;22(6):389-95. doi: 10.1007/s10654-007-9129-y. Epub 2007 May 5.
The epidemiology of cleft palate with multiple defects is often thought to be different from that of cleft palate alone, but there are few empirical data on this question. We explored this in a population-based data set created by combining data from two sources: the 1.8 million live births recorded from 1967 to 1998 in the Norwegian Birth Registry, and the two Norwegian surgical centers that repair cleft palate. Accompanying defects were identified from either source. Stratified analysis and logistic regression were used to assess relative risks by covariates. Of 1,431 babies with cleft palate, 31 % had another birth defect recorded by one or both sources. Prevalence of isolated cleft palate was steady over time, while cleft palate with other defects increased substantially. Girls had a higher risk of isolated cleft palate (relative risk 1.4; 95% confidence interval, 1.2-1.6) but not of cleft palate accompanied by other defects (1.1; 0.88-1.3). Older parents and parents who were first cousins had no increased risk of isolated cleft palate, but were twice as likely as others to have a baby with cleft palate accompanied by other defects. Risk factors differ between cases of cleft palate with and without accompanying defects.
腭裂合并多种缺陷的流行病学情况通常被认为与单纯腭裂不同，但关于这个问题的实证数据很少。我们通过合并两个来源的数据创建了一个基于人群的数据集来探讨这一问题：1967年至1998年挪威出生登记处记录的180万例活产数据，以及挪威两个修复腭裂的外科中心的数据。从任一来源确定伴随缺陷。采用分层分析和逻辑回归按协变量评估相对风险。在1431例腭裂婴儿中，31%有另一种出生缺陷被一个或两个来源记录。单纯腭裂的患病率随时间保持稳定，而伴有其他缺陷的腭裂患病率大幅上升。女孩患单纯腭裂的风险较高（相对风险1.4；95%置信区间，1.2 - 1.6），但患伴有其他缺陷的腭裂风险不高（1.1；0.88 - 1.3）。年龄较大的父母和近亲父母患单纯腭裂的风险没有增加，但他们生出伴有其他缺陷的腭裂婴儿的可能性是其他人的两倍。伴有和不伴有伴随缺陷的腭裂病例的风险因素有所不同。
