Global, Regional, and National Burden of Orofacial Clefts (1990-2021): Trends, inequalities and prediction to 2040.

IF 2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-08-07 DOI:10.1016/j.jormas.2025.102517

Zhiyan Wang, Yuanxi Luo, Zhichao Zhai, Tao Song

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引用次数: 0

Abstract

Background: Orofacial clefts (OFCs) are prevalent congenital anomalies, affecting approximately 1 in 700 live births globally. Despite surgical advancements reducing mortality, individuals face lifelong challenges.

Methods: We analyzed Global Burden of Disease (GBD) data (1990-2021) across 204 countries and territories, focusing on age-standardized incidence, disability-adjusted life years (DALYs), and mortality. Joinpoint regression identified temporal trends, spatial analysis with Getis-Ord Gi* statistics mapped hotspots, and health inequality was evaluated using Slope Index of Inequality and Concentration Index. Autoregressive Integrated Moving Average models projected burden to 2040.

Results: Global age-standardized incidence dropped from 3.80 to 2.96 per 100,000, with DALYs decreasing from 20.78 to 5.78 per 100,000 and mortality from 0.19 to 0.028 per 100,000. Low Socio-demographic Index regions had the highest 2021 DALY rate (8.65 per 100,000) compared to 2.23 in high Socio-demographic Index areas, with hotspots in Central Asia and the Horn of Africa. Absolute disparities worsened (Slope Index of Inequality:3.61 to -7.52), though relative inequality improved (Concentration Index: 0.192 to 0.147). By 2040, incidence is projected to fall to 2.25 per 100,000.

Discussion: Despite a global reduction in OFCs burden, socioeconomic disparities remain pronounced. Targeted interventions in hotspot regions and equitable healthcare strategies are essential to address persistent inequalities.

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全球、区域和国家口腔唇腭裂负担（1990-2021）：趋势、不平等和2040年预测。

背景：口面部唇裂（OFCs）是一种常见的先天性异常，全球每700例活产婴儿中就有一例受到影响。尽管外科手术的进步降低了死亡率，但个体仍面临着终身的挑战。方法：我们分析了204个国家和地区的全球疾病负担（GBD）数据（1990-2021），重点关注年龄标准化发病率、残疾调整生命年（DALYs）和死亡率。结合点回归识别时间趋势，空间分析采用Getis-Ord Gi*统计绘制热点，利用不平等斜率指数和浓度指数评价健康不平等。自回归综合移动平均模型预测到2040年的负担。结果：全球年龄标准化发病率从3.80 / 10万下降到2.96 / 10万，DALYs从20.78 / 10万下降到5.78 / 10万，死亡率从0.19 / 10万下降到0.028 / 10万。低社会人口指数地区的2021年DALY率最高（8.65 / 10万），而高社会人口指数地区的DALY率为2.23 / 10万，热点地区在中亚和非洲之角。绝对不平等加剧（不平等斜率指数从-3.61到-7.52），相对不平等改善（浓度指数从0.192到0.147）。到2040年，预计发病率将降至每10万人2.25例。讨论：尽管离岸金融中心的负担在全球范围内有所减轻，但社会经济差距仍然明显。热点地区有针对性的干预措施和公平的保健战略对于解决持续存在的不平等现象至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.