Corona-Rivera Jorge Román, Bobadilla-Morales Lucina, Corona-Rivera Alfredo, Peña-Padilla Christian, Olvera-Molina Sandra, Orozco-Martín Miriam A, García-Cruz Diana, Ríos-Flores Izabel M, Gómez-Rodríguez Brian Gabriel, Rivas-Soto Gemma, Pérez-Molina J Jesús
Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetic Unit, Pediatric Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico.
Department of Molecular Biology and Genomics, Health Sciences University Centre, "Dr. Enrique Corona-Rivera" Institute of Human Genetics, University of Guadalajara, Guadalajara, Mexico.
Congenit Anom (Kyoto). 2018 Jul;58(4):117-123. doi: 10.1111/cga.12276. Epub 2018 Mar 4.
We determined the overall prevalence of typical orofacial clefts and the potential risks for nonsyndromic cleft lip with or without cleft palate in a university hospital from West México. For the prevalence, 227 liveborn infants with typical orofacial clefts were included from a total of 81,193 births occurred during the period 2009-2016 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Guadalajara, Jalisco, Mexico). To evaluate potential risks, a case-control study was conducted among 420 newborns, including only those 105 patients with nonsyndromic cleft lip with or without cleft palate (cases), and 315 infants without birth defects (controls). Data were analyzed using multivariable logistic regression analysis expressed as adjusted odds ratio with 95% confidence intervals . The overall prevalence for typical orofacial clefts was 28 per 10,000 (95% confidence interval: 24.3-31.6), or 1 per 358 live births. The mean values for the prepregnancy weight, antepartum weight, and pre-pregnancy body mass index were statistically higher among the mothers of cases. Infants with nonsyndromic cleft lip with or without cleft palate had a significantly higher risk for previous history of any type of congenital anomaly (adjusted odds ratio: 2.7; 95% confidence interval: 1.4-5.1), history of a relative with cleft lip with or without cleft palate (adjusted odds ratio: 19.6; 95% confidence interval: 8.2-47.1), and first-trimester exposures to progestogens (adjusted odds ratio: 6.8; 95% CI 1.8-25.3), hyperthermia (adjusted odds ratio: 3.4; 95% confidence interval: 1.1-10.6), and common cold (adjusted odds ratio: 3.6; 95% confidence interval: 1.1-11.9). These risks could have contributed to explain the high prevalence of orofacial clefts in our region of Mexico, emphasizing that except for history of relatives with cleft lip with or without cleft palate, most are susceptible of modification.
我们确定了墨西哥西部一家大学医院中典型口面部裂隙的总体患病率以及非综合征性唇裂伴或不伴腭裂的潜在风险。关于患病率，从2009年至2016年期间在瓜达拉哈拉市“胡安·I·门查卡医生”市民医院（墨西哥哈利斯科州瓜达拉哈拉市）出生的81,193例活产婴儿中纳入了227例患有典型口面部裂隙的婴儿。为评估潜在风险，在420名新生儿中开展了一项病例对照研究，其中仅包括105例患有非综合征性唇裂伴或不伴腭裂的患者（病例组）以及315例无出生缺陷的婴儿（对照组）。数据采用多变量逻辑回归分析进行分析，以调整后的比值比及95%置信区间表示。典型口面部裂隙的总体患病率为每10,000例中有28例（95%置信区间：24.3 - 31.6），即每358例活产中有1例。病例组母亲的孕前体重、产前体重及孕前体重指数的平均值在统计学上更高。患有非综合征性唇裂伴或不伴腭裂的婴儿有任何类型先天性异常既往史的风险显著更高（调整后的比值比：2.7；95%置信区间：1.4 - 5.1）、有唇裂伴或不伴腭裂亲属史的风险显著更高（调整后的比值比：19.6；95%置信区间：8.2 - 47.1），以及孕早期接触孕激素的风险显著更高（调整后的比值比：6.8；95%置信区间1.8 - 25.3）、体温过高的风险显著更高（调整后的比值比：3.4；95%置信区间：1.1 - 10.6），以及患普通感冒的风险显著更高（调整后的比值比：3.6；95%置信区间：1.1 - 11.9）。这些风险可能有助于解释我们墨西哥地区口面部裂隙的高患病率，强调除了有唇裂伴或不伴腭裂亲属史外，大多数风险是可以改变的。
