Descriptive epidemiology of cleft lip and cleft palate in Western Australia

Authors

  • Jane C. Bell,

    Corresponding author
    1. School of Public Health, University of Sydney, New South Wales, Australia
    • Room 129A, Edward Ford Building A27, School of Public Health, University of Sydney, NSW 2006, Australia
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  • Camille Raynes-Greenow,

    1. School of Public Health, University of Sydney, New South Wales, Australia
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  • Carol Bower,

    1. Western Australian Register of Developmental Anomalies, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Western Australia, Australia
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  • Robin M. Turner,

    1. Screening and Test Evaluation Program, School of Public Health, University of Sydney, New South Wales, Australia
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  • Christine L. Roberts,

    1. Population Perinatal Health Research, Kolling Institute for Medical Research, University of Sydney, New South Wales, Australia
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  • Natasha Nassar

    1. Population Perinatal Health Research, Kolling Institute for Medical Research, University of Sydney, New South Wales, Australia
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  • Ms. Bell is supported by the Bob and Nancy Edwards Scholarship, University of Sydney.

    Dr. Raynes-Greenow is supported by a National Health and Medical Research Council (NHMRC) Early Career Research Fellowship (no. 511984)

    Prof. Bower is supported by a NHMRC Principal Research Fellowship (no. 634341).

    Dr. Turner is supported by a NHMRC program grant (no. 633003) to the Screening & Test Evaluation Program.

    Prof. Roberts is supported by a NHMRC Senior Research Fellowship (no. 1001066).

    Dr. Nassar is supported by a NHMRC Career Development Fellowship (no. 632955).

Abstract

Background

The reported birth prevalence of orofacial clefts (OFCs) varies considerably. This study describes the epidemiology of OFCs in an Australian population.

Methods

We studied infants diagnosed with cleft lip, with or without cleft palate (CL±P), and cleft palate only (CPO) since 1980 and reported to the population based Western Australian Register of Developmental Anomalies. We calculated prevalence rates by sex, Aboriginal status, geographic location, and socio-economic status. Associations between clefts and folate availability, pregnancy characteristics, pregnancy outcomes, other congenital anomalies, and age at diagnosis were also investigated.

Results

From 1980 to 2009, 917 infants with CL±P (12.05 per 10,000) and from 1980 to 2004, 621 infants with CPO (10.12 per 10,000) were registered. Prevalence rates for CL±P and CPO were 1.9 and 1.3 times higher, respectively, for Aboriginal Australians. Additional anomalies were reported for 31% of infants with CL±P and for 61% with CPO; chromosomal anomalies and other specific diagnoses accounted for 46% and 66%, respectively, of those with CL±P and CPO with additional anomalies. Almost all (99.7%) children with CL±P were diagnosed before 1 year of age, but 12% of CPO diagnoses were made after 1 year of age; 94% of these diagnoses were of submucous clefts and bifid uvula.

Conclusions

These data provide a picture of the prevalence of OFCs in WA since 1980, and provide a useful reference for OFC data in Australia and internationally. The quality and completeness of the WARDA data are high, reflected in high prevalence rates, and proportions of clefts occurring with other anomalies. Birth Defects Research (Part A), 2013 © 2013 Wiley Periodicals, Inc.

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