Alsabawi Yossef, Dadzie Aaron, Baker Kelsey
Medical Education, The University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.
Neuroscience, The University of Texas Rio Grande Valley, Edinburg, USA.
Cureus. 2025 May 27;17(5):e84899. doi: 10.7759/cureus.84899. eCollection 2025 May.
Background Orofacial clefts (OFCs), including the cleft lip with or without cleft palate (CLP) and cleft palate alone (CP), represent significant congenital anomalies with implications for feeding, speech, and psychosocial development. The Rio Grande Valley (RGV) of Texas, a predominantly Hispanic region that faces socioeconomic and healthcare challenges, may have a distinct OFC profile compared to non-border counties (NBCs) of Texas. Methods Prevalence data with 95% confidence intervals for OFCs from 1997 to 2018 were obtained from the Texas Department of State Health Services (DSHS). Definitions provided by the DSHS were adhered to, including only definite diagnoses. Given the large sample sizes and annual prevalence, a two-tailed z-score analysis was utilized to compare the RGV with NBCs, assuming normal approximation per the central limit theorem. Hispanic mothers were selected as the study population to minimize confounding by ethnicity, as the RGV has a predominantly Hispanic population. Results Overall, the prevalence of CLP among children born to Hispanic mothers in the RGV was higher than in NBCs ( = 0.26). The prevalence of CLP from 2008 to 2018 was significantly higher in the RGV than in NBCs ( = 0.006). From the first decade (1997-2007) to the second (2008-2018), the prevalence of CLP decreased significantly in NBCs ( = 0.016) and increased in the RGV ( = 0.06). No significant differences in the prevalence of CP were found across regions or time. Conclusion These findings suggest divergent temporal trends between CLP in the RGV versus NBCs. Therefore, there is a need for targeted public health interventions, given potential reporting limitations. Enhanced surveillance, improved diagnostic reporting (particularly in medically underserved and undocumented populations), and further research into environmental and socioeconomic determinants are warranted.
背景 口面部裂隙(OFCs),包括唇裂伴或不伴腭裂(CLP)以及单纯腭裂(CP),是具有重要意义的先天性异常,会影响喂养、言语及心理社会发育。得克萨斯州的里奥格兰德河谷(RGV)是一个主要为西班牙裔的地区,面临社会经济和医疗保健方面的挑战,与得克萨斯州的非边境县(NBCs)相比,其OFC情况可能有所不同。方法 从得克萨斯州州立卫生服务部(DSHS)获取1997年至2018年OFCs的患病率数据及95%置信区间。遵循DSHS提供的定义,仅纳入明确诊断的病例。鉴于样本量较大及年度患病率情况,根据中心极限定理假设正态近似,采用双尾z分数分析将RGV与NBCs进行比较。选择西班牙裔母亲作为研究人群,以尽量减少种族因素造成的混杂,因为RGV主要是西班牙裔人口。结果 总体而言,RGV地区西班牙裔母亲所生孩子中CLP的患病率高于NBCs地区( = 0.26)。2008年至2018年期间,RGV地区CLP的患病率显著高于NBCs地区( = 0.006)。从第一个十年(1997 - 2007年)到第二个十年(2008 - 2018年),NBCs地区CLP的患病率显著下降( = 0.016),而RGV地区则上升( = 0.06)。各地区或不同时间CP的患病率均未发现显著差异。结论 这些发现表明RGV地区与NBCs地区CLP的时间趋势存在差异。因此,鉴于可能存在的报告局限性,有必要采取有针对性的公共卫生干预措施。加强监测、改善诊断报告(特别是在医疗服务不足和无证人群中)以及进一步研究环境和社会经济决定因素是必要的。