Butts Sydney C, Reynolds Simone, Gitman Lyuba, Patel Prayag, Joseph Michael
1 Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, State University of New York-Downstate Medical Center, New York, NY, USA.
2 Department of Epidemiology, School of Public Health, State University of New York-Downstate Medical Center, New York, NY, USA.
Cleft Palate Craniofac J. 2018 Oct;55(9):1191-1199. doi: 10.1177/1055665618770192. Epub 2018 Apr 17.
To determine the role of racial background, public health initiatives, and residence on the prevalence of orofacial clefts (OFCs) in New York City (NYC).
DESIGN/METHODS: Retrospective review of OFC cases from the New York State Congenital Malformations Registry.
PATIENTS/PARTICIPANTS: Patients born with an OFC and all live births to mothers residing in NYC between 1983 and 2010.
Orofacial cleft birth prevalence by cleft type, race, and borough of maternal residence for each year and by time period around the implementation of public health interventions including folate supplementation.
A total of 3557 cases were reviewed. The prevalence remained stable for cleft palate and cleft lip with or without cleft palate (CL ± P) in sequential time periods of the study. Among CL ± P cases, cleft lip prevalence decreased early in the study compared to increases in cleft lip and palate prevalence. For most years, the prevalence of OFCs was lower among African Americans than whites. A total of 12% to 26% of mothers in 4 of the NYC boroughs deliver outside of their borough of residence, choosing to give birth in Manhattan most often. No difference in OFC prevalence was shown in any of the 5 NYC boroughs.
The period prevalence remained relatively stable during the time periods before and after the implementation of folate supplementation for OFCs in NYC. Prevalence of OFC subtypes was lower for most time periods during this study among African Americans compared to whites. Several factors may explain the choice of birthplace outside of the mother's borough of residence.
确定种族背景、公共卫生举措及居住地点对纽约市口面部裂隙（OFC）患病率的影响。
设计/方法：对纽约州先天性畸形登记处的OFC病例进行回顾性研究。
患者/参与者：1983年至2010年间出生时患有OFC的患者以及居住在纽约市的母亲所生的所有活产儿。
按年份、裂隙类型、种族以及母亲居住行政区划分的口面部裂隙出生患病率，以及在包括补充叶酸在内的公共卫生干预措施实施前后各时间段的患病率。
共审查了3557例病例。在研究的连续时间段内，腭裂以及唇裂伴或不伴腭裂（CL±P）的患病率保持稳定。在CL±P病例中，与唇腭裂患病率增加相比，研究早期唇裂患病率有所下降。在大多数年份，非裔美国人的OFC患病率低于白人。纽约市4个行政区中共有12%至26%的母亲在其居住行政区以外的地方分娩，其中大多数选择在曼哈顿分娩。纽约市5个行政区中任何一个行政区的OFC患病率均无差异。
在纽约市对OFC实施补充叶酸前后的时间段内，期间患病率保持相对稳定。在本研究的大多数时间段内，非裔美国人的OFC亚型患病率低于白人。有几个因素可以解释母亲选择在其居住行政区以外的地方分娩的原因。
