Trends in orofacial cleft prevalence and the effect of prenatal detection on pregnancy outcomes in Northern Netherlands

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-09-18 DOI:10.1016/j.annepidem.2025.09.012

Sofia Anania MD , Marian K. Bakker PhD , Jorieke E.H. Bergman MD PhD , Leonie K. Duin MD PhD , Mike Ruettermann MD PhD , Dieuwke C. Broekstra PhD

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引用次数: 0

Abstract

Objectives

To describe trends in total and live birth (LB) prevalence of orofacial clefts (OFCs) and investigate the effect of prenatal diagnosis on its LB prevalence in the Northern Netherlands (NNL) over a 21-year period.

Study design

Cases with OFCs were selected from Eurocat NNL, a population-based registry of congenital anomalies. Aggregated denominator data (controls) was derived from Statistics Netherlands. We categorized OFCs into cleft lip with or without palate (CL±P) and cleft palate (CP). We analyzed trends in prevalence and temporal patterns in prenatal detection rates and birth type by calculating the annual percentage change (APC) using Joinpoint regression or the X² test for linear trends.

Results

The total prevalence of CL±P decreased non-significantly from 1.65/1000 births in 2001 to 1.17/1000 births in 2021 (APC=-0.82 [95 %CI: −2.18, 0.55]), whereas the LB prevalence decreased significantly from 1.57/1000 births in 2001 to 0.93/1000 births in 2021 (APC=-1.65 [95 %CI −3.03, −0.25]). The total and LB prevalence of CP did not show significant decreasing trends.

The prenatal detection rate of CL±P increased from 15 % to 71 % between 2001 and 2007 (APC=34.38 [95 %CI 24.27, 52.26]), followed by a slower increase, reaching 94 % in 2021 (APC=3.57 [95 %CI 0.59, 6.08]). The percentage of induced abortions increased from 3.2 % to 12.7 % between 2001 and 2021 (X² for trend P < 0.001), with most induced abortions occurring in the CL±P associated with genetic/syndromic or other congenital anomalies.

Conclusions

The LB prevalence of CL±P decreased, which may be associated with better prenatal detection and increasing pregnancy terminations due to unfavorable prognosis

查看原文本刊更多论文

荷兰北部口腔面部裂流行趋势及产前检测对妊娠结局的影响。

目的：描述口腔面部唇裂（OFCs）的总患病率和活产患病率的趋势，并调查产前诊断对北荷兰（NNL） 21年期间的LB患病率的影响。研究设计：OFCs病例选择自Eurocat NNL，一个基于人群的先天性异常登记。汇总分母数据（对照）来自荷兰统计局。我们将OFCs分为有腭裂或无腭裂（CL±P）和腭裂（CP）。我们分析了产前检出率和出生类型的流行趋势和时间模式，通过使用Joinpoint回归或线性趋势的X²检验计算年百分比变化（APC）。结果：CL±P总患病率从2001年的1.65/1000例下降至2021年的1.17/1000例（APC=-0.82 [95%CI: -2.18, 0.55]），而LB患病率从2001年的1.57/1000例下降至2021年的0.93/1000例（APC=-1.65 [95%CI: -3.03, -0.25]）。CP总患病率和LB患病率无明显下降趋势。产前CL±P检出率从2001年的15%上升到2007年的71% (APC=34.38 [95%CI 24.27, 52.26])，随后缓慢上升，到2021年达到94% （APC=3.57 [95%CI 0.59, 6.08]）。2001年至2021年，人工流产率从3.2%上升至12.7% （X2为趋势P）。结论：CL±P的LB患病率下降，可能与产前检查的改善和预后不良导致终止妊娠的增加有关。

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

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.