Koga Hiroshi, Iida Koichi, Maeda Tomoki, Takahashi Mizuho, Fukushima Naoki, Goshi Terufumi
Department of Pediatrics, National Hospital Organization Beppu Medical Center, Oita, Japan.
Department of Neonatology, Oita Prefectural Hospital, Oita, Japan.
PLoS One. 2016 Feb 22;11(2):e0149773. doi: 10.1371/journal.pone.0149773. eCollection 2016.
To investigate malformations associated with cleft lip and cleft palate, we conducted surveys at neonatal intensive care units (NICUs) and other non-NICU facilities and to determine whether there are differences among facilities. The regional survey investigated NICU facilities located in Oita Prefecture, including 92 patients with cleft lip and palate (CLP) or cleft palate (CP) that occurred between 2004 and 2013, and the national survey investigated oral surgery, plastic surgery, and obstetrics and gynecology facilities located in Japan, including 16,452 patients with cleft lip (CL), CLP, or CP that occurred since 2000. The incidence per 10,000 births was 4.2, 6.2, and 2.8 for CL, CLP, and CP, respectively, according to the national survey, and 6.3 and 2.9 for CLP and CP, respectively according to the regional survey. These results indicated comparable incidences between the two surveys. In contrast, when the survey results on malformations associated with CLP and CP according to the ICD-10 classification were compared between the national survey conducted at oral surgery or plastic surgery facilities and the regional survey conducted at NICU facilities, the occurrence of associated malformations was 19.8% vs. 41.3% for any types of associated malformation, 6.8% vs. 21.7% for congenital heart disease, and 0.5% vs. 16.3% for chromosomal abnormalities. These results indicated that the incidences of all of these associated malformations were significantly greater in the survey conducted at NICU facilities and similar to the findings from international epidemiological surveys. When comparing the survey conducted at obstetrics facilities vs. NICU facilities, the occurrence of associated malformations was similar results as above. The incidence of CLP and CP was not different between surveys conducted at NICU facilities vs. non-NICU facilities; however, when conducting surveys on associated malformations, it is possible to obtain accurate epidemiological data by investigating NICU facilities where detailed examinations are thoroughly performed.
为了调查与唇腭裂相关的畸形情况，我们在新生儿重症监护病房（NICU）和其他非NICU机构进行了调查，以确定不同机构之间是否存在差异。区域调查针对位于大分县的NICU机构展开，调查对象为2004年至2013年间出现的92例唇腭裂（CLP）或腭裂（CP）患者；全国调查则针对位于日本的口腔外科、整形外科以及妇产科机构，调查对象为2000年以来出现的16452例唇裂（CL）、CLP或CP患者。根据全国调查，每10000例出生中CL、CLP和CP各自的发病率分别为4.2、6.2和2.8；根据区域调查，CLP和CP的发病率分别为6.3和2.9。这些结果表明两次调查的发病率具有可比性。相比之下，当比较在口腔外科或整形外科机构进行的全国调查与在NICU机构进行的区域调查中，根据国际疾病分类第十版（ICD - 10）分类的与CLP和CP相关的畸形调查结果时，任何类型相关畸形的发生率分别为19.8%和41.3%，先天性心脏病的发生率分别为6.8%和21.7%，染色体异常的发生率分别为0.5%和16.3%。这些结果表明，在NICU机构进行的调查中，所有这些相关畸形的发生率显著更高，且与国际流行病学调查结果相似。当比较在产科机构与NICU机构进行的调查时，相关畸形的发生率与上述结果相似。NICU机构与非NICU机构进行的调查中CLP和CP的发病率并无差异；然而，在对相关畸形进行调查时，通过调查能够进行全面详细检查的NICU机构，可以获得准确的流行病学数据。
