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口腔面部裂隙与不良出生健康结局:一项人群横断面研究。

Orofacial Cleft and Poor Birth Health Outcomes: A Populational Cross-Sectional Study.

作者信息

Silva Adriana Mendonça da, Freitas Valéria Souza, Vieira Alexandre Rezende

机构信息

Department of Health, State University of Feira de Santana, Feira de Santana, BA, Brazil.

Arizona School of Dentistry and Oral Health, A. T. Still University, Mesa, Arizona.

出版信息

Am J Perinatol. 2025 May 21. doi: 10.1055/a-2598-9487.

Abstract

This study aimed to examine whether newborns with orofacial clefts are at increased prevalence of poor birth health outcomes.This is a population-based cross-sectional study, conducted with information from 25,879,282 live births registered in the U.S. Vital Statistics Natality Birth Data from 2017 to 2023. The prevalence ratios and logistic regression models between orofacial cleft status (all, isolated, or nonisolated) and each child's birth health variables (delivery method, maternal morbidity, 5-minute Apgar score, gestational age, birth weight, abnormal conditions, infant breastfed at discharge) were calculated, assuming a ≤ 0.05 as statistically significant.The prevalence ratios showed that newborns with orofacial clefts were more susceptible to being born by cesarean section (prevalence ratio [PR] = 1.18,  = 0.000, 95% confidence interval [CI] = 1.16-1.21), having lower birth weight (PR = 2.18,  = 0.000, 95% CI = 2.11-2.25), lower Apgar 5 score (PR = 4.08,  = 0.000, 95% CI = 4.08-4.50), prematurity (PR = 1.55,  = 0.000, 95% CI = 1.50-1.60), experiencing more abnormal conditions at birth (PR = 3.72,  = 0.000, 95% CI = 3.64-3.80), and having more difficulty to be breastfed (PR = 2.16,  = 0.000, 95% CI = 2.11-2.22) than newborns without clefts. These ratios were even higher among those with nonisolated orofacial clefts. Associations were statistic significant even after adjustments.This study provides evidence that newborns with orofacial clefts are at increased prevalence of poor birth health outcomes. · Orofacial clefts are associated to higher prevalence of birth outcomes.. · Newborns with orofacial clefts were more susceptible to have low birth weight.. · Newborns with orofacial clefts were more susceptible to preterm birth..

摘要

本研究旨在探讨患有口面部裂隙的新生儿出生时健康状况不佳的患病率是否增加。这是一项基于人群的横断面研究,使用了2017年至2023年美国生命统计出生数据中登记的25,879,282例活产信息。计算了口面部裂隙状态(全部、孤立性或非孤立性)与每个孩子的出生健康变量(分娩方式、孕产妇发病率、5分钟阿氏评分、胎龄、出生体重、异常情况、出院时母乳喂养情况)之间的患病率比值和逻辑回归模型,假设P≤0.05具有统计学意义。患病率比值显示,与无口面部裂隙的新生儿相比,患有口面部裂隙的新生儿更易通过剖宫产出生(患病率比值[PR]=1.18,P=0.000,95%置信区间[CI]=1.16-1.21)、出生体重较低(PR=2.18,P=0.000,95%CI=2.11-2.25)、阿氏5分钟评分较低(PR=4.08,P=0.000,95%CI=4.08-4.50)、早产(PR=1.55,P=0.000,95%CI=1.50-1.60)、出生时出现更多异常情况(PR=3.72,P=0.000,95%CI=3.64-3.80)以及母乳喂养困难更多(PR=2.16,P=0.000,95%CI=2.11-2.22)。这些比值在非孤立性口面部裂隙患者中更高。即使经过调整,关联仍具有统计学意义。本研究提供了证据表明,患有口面部裂隙的新生儿出生时健康状况不佳的患病率增加。·口面部裂隙与出生结局的较高患病率相关。·患有口面部裂隙的新生儿更易出生体重低。·患有口面部裂隙的新生儿更易早产。

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