Research Unit, Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Arch Dis Child Fetal Neonatal Ed. 2011 May;96(3):F212-6. doi: 10.1136/adc.2010.193599. Epub 2010 Nov 11.
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.
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.
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.
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.
荷兰新增口腔裂患者人数减少。这可以用两种假说解释：（1）先天畸形的产前检出率提高导致更多妊娠终止；（2）叶酸使用增加降低了口腔裂风险。这两种假说主要适用于唇裂/牙槽裂伴或不伴腭裂（CL±P），因为与单纯腭裂（CP）不同，CL±P 可通过二维（2D）超声在产前检出，且在推荐叶酸使用时期内发育。作者旨在确定 1997-2006 年间的流行趋势，并通过按裂型分层来评估这些假说。
这是一项对荷兰 1997-2006 年间活产口腔裂婴儿的时间趋势分析，这些婴儿均登记在全国口腔裂登记处。作者计算了所有口腔裂及两个裂型的流行率和估计年百分比变化（EAPC）。
1997-2006 年间，在 1970872 例活产儿中有 3308 例患有口腔裂，每 10000 例活产儿中有 16.8 例（CL±P：11.3；CP：5.5）。时间趋势分析显示，所有口腔裂的流行率均下降（EAPC-1.8%；95%CI：-3.0%至-0.6%），CL±P 的流行率也下降（EAPC-2.3%；95%CI：-3.8%至-0.9%）。CP 的流行率没有显著变化。
由于 CL±P 的活产流行率下降，所有口腔裂的流行率也随之下降。这些发现与两种假说一致，因此可能对产前咨询和叶酸政策产生影响。
