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Kumar B, Singh P, Ranjan A, Singh T, Singh N, Kriti, Singh S, Singh S, Mishra N, Sharma AK. Congenital cardiac anomalies in non-syndromic cleft lip and cleft palate patients: A systematic review and meta-analysis. Congenit Anom (Kyoto) 2024; 64:143-154. [PMID: 38530019 DOI: 10.1111/cga.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
The aim was to establish a specific and definite connection between non-syndromic orofacial cleft patients and associated congenital heart disease (CHD). Following PRISMA guidelines, selective databases were searched for data collection. Studies showing a definite association of CHD with orofacial cleft were included, and studies non-specific of the association of orofacial cleft with CHD were excluded. Data extraction criteria were study design, frequency of CHD in overall non-syndromic orofacial cleft and in specific cleft type, and most prevalent congenital cardiac anomaly. DerSimonian Laird random effects model was used to estimate the pooled proportion of CHD, along with corresponding 95% confidence intervals (CIs) for each measure. Publication bias was assessed using Fail-Safe N analysis and the Rosenthel approach. Of a total of 182 articles searched, only 30 studies were assessed. The overall pooled estimate of the proportion of CHD in total cleft lips/palates was 16% (95% CI: 13-19). The odds of developing CHD in cleft palates was 4.08 times more as compared to cleft lips with 95% CIs of 3.86-4.33, and 1.65 more as compared to cleft lips and palates both with 95% CI of 1.52-1.68. We affirm the upsurging prevalence of CHD in non-syndromic cleft children and vehemently propose that it is of utmost importance to inculcate it in practice and policy-making to screen all non-syndromic orofacial cleft children for congenital cardiac anomaly. This study was registered on PROSPERO (ID no. CRD42023391597) on February 24, 2023.
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Affiliation(s)
- Bindey Kumar
- Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Priyankar Singh
- Unit of Cranio-Maxillo-Facial Surgery, Post Graduate Institute of Dental Education & Research, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Alok Ranjan
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Tulika Singh
- Community and Family Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Nimmi Singh
- Oral Medicine and Radiology, Post Graduate Institute of Dental Education & Research, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Kriti
- Prosthodontist and Anaplastologist, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Swati Singh
- Periodontology, Post Graduate Institute of Dental Education & Research, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Siddharth Singh
- General Medicine, Unit of Emergency Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Navin Mishra
- Conservative and Endodontics, Post Graduate Institute of Dental Education & Research, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Arbind Kumar Sharma
- Post Graduate Institute of Dental Education & Research, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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Sabbagh HJ, Alghamdi SM, Abdulhameed FD, Alhussain RM, Alrejaye NS, AlGudaibi LY, Sallout BI, Albaqawi BS, Alnamnakani EA, Brekeit LK, Alsharif MT, Alshaikh AB, Almalik MI, Aburiziza AJ, Al Soqih NS, Alqhtani FA, Alghamdi BM, Alraddadi AK, Aljohar AJ, Basri OA, Alamoudi RA. Incidence of non-syndromic orofacial cleft during the COVID-19 pandemic in Saudi Arabia. BMC Public Health 2023; 23:2538. [PMID: 38114928 PMCID: PMC10729427 DOI: 10.1186/s12889-023-17270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES This is the first national study to investigate the incidence of non-syndromic oro-facial clefts (NSOFC) and Pierre-Robin-Sequence in Saudi Arabia over the Covid-19 pandemic period. METHODS All maternity hospitals (30-hospitals) in the major regions and cities of Saudi from November 2020-to-2021 were included in the study. Patients were evaluated for cleft phenotype using the LASHAL-classification system. The incidence of NSOFC in Saudi Arabia was calculated by comparing the number of NSOFCs cases born out of all live births during the study period at the included hospitals. Clinical examination was performed and information was gathered using a validated data collection form. RESULTS In one year, 140,380 live-infants were born at the selected hospitals. Of these, 177 were diagnosed with NSOFC giving an incidence of 1.26/1,000 live-births in Saudi Arabia and the highest incidence in Medina city (2.46/1000 live-births). The incidence of cleft lip-and-palate (0.67/1000 live-births) was higher than that of cleft-palate (0.37/1000 live-births) and cleft-lip (0.22/1000 live-births). Pierre-Robin Sequence incidence was (0.04/1000 live-births). There were 21(12.1) or 23(13.2%) of NSOFC's mothers exposed or vaccinated with Covid-19, respectively. CONCLUSION The national incidence of NSOFC in Saudi Arabia was 1.26/1000 live births with variation between phenotypes and regions in the country. In addition, to reporting Covid-19 infection prevalence and vaccine exposure among NSOFC's mothers, this study represents the first of its type to evaluate NSOFC prevalence in Saudi Arabia on a national level.
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Affiliation(s)
- Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
| | - Sultan Musaad Alghamdi
- Pediatric Dentistry Department, Bisha Dental Centre, Ministry of Health, Bisha, Saudi Arabia
| | - Fatma Dawood Abdulhameed
- Pediatric Surgery Department, King Salman Medical City, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Reema Mahdi Alhussain
- Pediatric Dentistry Department, Dammam Medical Complex, Eastern health cluster, Eastern Province, Dammam, Saudi Arabia
| | - Najla Sulaiman Alrejaye
- Orthodontics, King Abdullah International Medical Research CenterConsultant in Craniofacial Orthodontics, Department of Dentistry, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, College of Dentistry, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Latifa Yousef AlGudaibi
- Saudi Board of Orthodontics and Dentofacial Orthopedics Program, King Saud Bin Abdulaziz University for Health Sciences, College of Dentistry; King Abdullah International Medical Research Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Bahauddin Ibraheem Sallout
- Obstetrics and Gynecology, Maternal Fetal Medicine, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Badi Shoaib Albaqawi
- Maternal Fetal Medicine, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Lougin Khalid Brekeit
- Orthodontics and Dentofacial Orthopedics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mona Tala Alsharif
- Department of Dental Public Health, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Ali Bakr Alshaikh
- Saudi Board of pediatric dentistry, Riyadh Elm University, College of Dentistry, Riyadh, Saudi Arabia
| | | | | | - Norah Suliman Al Soqih
- Department of Pediatrics, Qassim University, College of Medicine, Buraidah, Saudi Arabia
| | - Faisal Ali Alqhtani
- Pediatric Dentistry Department, King Khalid University, Faculty of Dentistry, Abha, Saudi Arabia
| | | | | | - Aziza Johar Aljohar
- Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Osama Adel Basri
- King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Rana Abdullah Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, 21589, Jeddah, Saudi Arabia.
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Eltyeb EE, Halawi MHA, Tashari TBM, Alharbi K, Alsayari OS, Albarrak DA, Eltayeb RA, Al-Makramani AAA, Medani IEM. Prevalence and Pattern of Birth Defects in Saudi Arabia: A Systematic Review of Observational Studies. Pediatr Rep 2023; 15:431-441. [PMID: 37489414 PMCID: PMC10366848 DOI: 10.3390/pediatric15030040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/15/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Birth defects are a significant concern since they can lead to permanent disability and death. This study comprehensively reviews the prevalence and patterns of birth defects in Saudi Arabia. METHODS A systematic analysis of the literature retrieved from three databases (Pub Med, Science Direct, and the Saudi digital library) published between 1989 and 2022 was performed. Observational studies that addressed the prevalence and patterns of birth defects in Saudi Arabia were chosen based on the eligibility criteria, while systematic reviews, review articles, non-relevant articles, and studies that did not fulfill the eligibility criteria were excluded. Quality and risk of bias were evaluated based on the JBI and GRADE tools, respectively. RESULTS We identified 26 eligible publications of 1277 records that included 297,668 patients from different regions of Saudi Arabia. The highest overall prevalence of birth defects was 46.5 per 1000 live births compared to a lowest rate of 8.6 per 1000 in one study. Several studies have reported positive associations of consanguinity, maternal folic acid supplementation, family history of birth defects or genetic abnormalities, and maternal co-morbidities. The most frequent birth defects include cardiac, genitourinary, craniofacial, and nervous system defects. CONCLUSION Robust findings have improved our understanding of the prevalence and pattern of birth defects in Saudi Arabia. Importantly, future studies will likely require multicenter collaboration to arrive at appropriate sample sizes in the context of the effects of risk factors on elevated prevalence. Furthermore, quantitative data require careful evaluation in more complex statistical models.
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Affiliation(s)
| | | | | | - Khaled Alharbi
- Imam Abdulrahman Alfaisal Hospital, Riyadh 14723, Saudi Arabia
| | - Ohoud Saad Alsayari
- College of Medicine, King Saud bin Abdulaziz University, Riyadh 14611, Saudi Arabia
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Farshidfar N, Ajami S, Sahmeddini S, Goli A, Foroutan HR. Epidemiological and Spatiotemporal Descriptive Analysis of Patients with Nonsyndromic Cleft Lip and/or Palate: A 12-Year Retrospective Study in Southern Iran. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7624875. [PMID: 37124932 PMCID: PMC10132907 DOI: 10.1155/2023/7624875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/20/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023]
Abstract
Objectives The current study is aimed at evaluating epidemiological characteristics and spatiotemporal distribution of cleft lip and/or palate (CL/P) in the south of Iran. Methods Data were extracted from the 1840 medical records of patients who were referred to the Cleft Lip and Palate Center of Shiraz University of Medical Sciences, from January 1, 2011, to September 1, 2022. The collected variables included demographic data (gender, birth date and season, place, birth order, and weight), cleft types and the subtypes, parental information (health status, education level, marital status, and age during the pregnancy), and other basic parameters. The chi-square test at a significance level of 0.05 was used to analyze collected data. The geographic information system (GIS) analysis was also used for analyzing the spatial distribution of CL/P patients. Results Based on our inclusion criteria, 1281 nonsyndromic patients were included in this study. The most common type was cleft lip and palate (CLP) with 48.32%, whereas cleft palate (CP) and cleft lip (CL) accounted for 40.75% and 10.93% of the patients, respectively. There was a progressive increase in the frequency of all types of clefts, and most of them were male (P ≤ 0.001). The urban population outnumbered the rural ones in all provinces. Parents were mostly healthy (>80%) with low educational status (47.5%). Most born CL/P patients were from consanguineous marriages (58.9%), especially between first-degree relatives. A majority of CL/P patients (73.1%) were born in the first two gestations with a birth weight of 2500-4000 g (77.4%). Most infants with CL/P (84.3%) were born from mothers who had at least one of the predisposing factors. Conclusion In this study, the frequency of cleft types and subtypes was similar to the existing literature. However, high rate of consanguineous marriage, especially between first-degree relatives, was the most notable feature of this population.
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Affiliation(s)
- Nima Farshidfar
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shabnam Ajami
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sarina Sahmeddini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Goli
- Department of Sociology & Social Planning, Shiraz University, Shiraz, Iran
| | - Hamid Reza Foroutan
- Department of Surgery, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Sithole PA, Motshabi-Chakane P, Muteba MK. The characteristics and perioperative outcomes of children with orofacial clefts managed at an academic hospital in Johannesburg, South Africa. BMC Pediatr 2022; 22:214. [PMID: 35440073 PMCID: PMC9016974 DOI: 10.1186/s12887-022-03267-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background Orofacial clefts (OFCs) are the commonest congenital anomalies of the head and neck. Their aetiology is multifactorial, and prevalence has a geographical variation. This study sought to describe OFC cases that presented for surgery. Objectives The study aimed to describe the preoperative characteristics, concomitant congenital anomalies and perioperative outcomes of children presenting for cleft repair surgery over a 5-year period at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods A retrospective descriptive record review for children under the age of 14 years who presented for cleft repair surgery at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) during a 5-year period, from 1 January 2014 to 31 December 2018. Descriptive and comparative statistics were used to report the results. Results A total of 175 records were included in the study. The median (IQR) age was 11 (6—27) months, with a predominance of males 98 (56%). Most of the children had cleft lip and palate (CLP) 71(41%). The prevalence of concomitant congenital anomalies was 22%, emanating mostly from head and neck congenital anomalies. Nine syndromes were identified in 15 children with syndromic clefts. Twenty-nine percent of children were underweight for age. There were 25 anaesthetic related complications, commonly airway related. Six children with complex multiple congenital anomalies were admitted in the intensive care unit postoperatively. No mortalities were recorded. Conclusion Majority of children with orofacial clefts underwent cleft repair surgery without serious complications and intensive care unit admission. Only six children were diagnosed with significant anomalies needing intensive care management.
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Affiliation(s)
- Prosperity A Sithole
- Department of Anaesthesiology, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - Michel K Muteba
- Department of Anaesthesiology, University of the Witwatersrand, Johannesburg, South Africa
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Decreasing Incidence of Palatoplasty in the United States. J Craniofac Surg 2021; 32:2710-2712. [PMID: 34231517 DOI: 10.1097/scs.0000000000007799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Cleft palate is amongst the most common birth defect across the world. Although its etiology is multifactorial, including genetic and environmental contributors, the investigators were interested in exploring whether its incidence was changing over time. METHODS The Nationwide Inpatient Sample database, the largest publically available healthcare database in the United States, was used to identify all primary palatoplasties performed under 2 years of age and births which occurred over a 17-year period from 1999 to 2015. The change in rate of palatoplasties and overall maternal demographics were assessed longitudinally using the chi-squared test. Significance level was set at P < 0.001. RESULTS A total of 13,808,795 pregnancies were reviewed during the time period, from 1999 to 2015, inclusively. A total of 10,567 primary palatoplasties were performed in that period of time reflecting an overall rate of 7.7 palatoplasties per 10,000 deliveries. Palatoplasty rates decreased across the study period from 9.5 per 10,000 in 1999 to 7.1 per 10,000 died/delivered pregnancies in 2015 which corresponds to an average compounded year-to-year decrease of 1.76%, P < 0.001. CONCLUSIONS The rate of primary palatoplasties, as a proxy for the rate of cleft palate prevalence, has been significantly decreasing over the last 2 decades and may represent improvements in early diagnosis in pregnancy, changing genetic or racial demographics, and/or environmental factors such as decreased maternal smoking in the US population. Future research may be directed at better understanding the definitive etiology of this decreasing prevalence of children undergoing primary cleft palate repairs in the United States.
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Alawi KA, Shaqsi SA, Ghaithi MA. Awareness of Orofacial Clefts in the Sultanate of Oman. Cleft Palate Craniofac J 2021; 59:708-714. [PMID: 34137299 DOI: 10.1177/10556656211024477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Cleft lip and/or palate (CL/P) is the most common craniofacial anomaly. In Oman, the incidence of CL/P is estimated to be 1.5 per 1000 live births per year. Knowledge, awareness, and attitude toward CL/P help to optimize the management of the condition and reduce social and emotional stress among this group of children and their family. In this survey, we assessed the public awareness, knowledge, and attitude toward this deformity in the Sultanate of Oman. METHOD A cross-sectional study was conducted using validated questionnaire that was distributed using Google forms. RESULT A total of 739 participants completed the survey. The majority is aware of cleft lip (86.7%) and palate (63.2%). In general, attitude toward patients with CL/P was positive. Females had higher knowledge compared to males, 54.4% and 32.9%, respectively. Online resources were the main source of information. CONCLUSION There are variations in knowledge, awareness, and attitude toward CL/P among participants. Omani population needs to be educated more about CL/P, its complications if not treated, and the available treatment.
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Affiliation(s)
- Khalifa Al Alawi
- Department of Plastic & Reconstructive Surgery, Khoula Hospital, Muscat, Oman
| | - Sultan Al Shaqsi
- Department of Plastic & Reconstructive Surgery, University of Toronto, Ontario, Canada
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Sanchez MLN, Benjamin RH, Mitchell LE, Langlois PH, Canfield MA, Swartz MD, Scheuerle AE, Scott DA, Northrup H, Schaaf CP, Ray JW, McLean SD, Chen H, Lupo PJ, Agopian AJ. Birth Defect Co-Occurrence Patterns Among Infants With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2021; 59:417-426. [PMID: 33906455 DOI: 10.1177/10556656211010060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate 2- to 5-way patterns of defects co-occurring with orofacial clefts using data from a population-based registry. DESIGN We used data from the Texas Birth Defects Registry for deliveries between 1999 and 2014 to Texas residents, including 1884 cases with cleft palate (CP) and 5289 cases with cleft lip with or without cleft palate (CL±P) without a known syndrome. We identified patterns of defects co-occurring with CP and with CL±P observed more frequently than would be expected if these defects occurred independently. We calculated adjusted observed-to-expected (O/E) ratios to account for the known tendency of birth defects to cluster nonspecifically. RESULTS Among infants without a syndrome, 23% with CP and 21% with CL±P had at least 1 additional congenital anomaly. Several combinations of defects were observed much more often than expected. For example, the combination of CL±P, congenital hydrocephaly, anophthalmia, and other nose anomalies had an O/E ratio of 605. For both CP and CL±P, co-occurrence patterns with the highest O/E ratios involved craniofacial and brain abnormalities, and many included the skeletal, cardiovascular, and renal systems. CONCLUSIONS The patterns of defects we observed co-occurring with clefts more often than expected may help improve our understanding of the relationships between multiple defects. Further work to better understand some of the top defect combinations could reveal new phenotypic subgroups and increase our knowledge of the developmental mechanisms that underlie the respective defects.
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Affiliation(s)
- Maria Luisa Navarro Sanchez
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Renata H Benjamin
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Laura E Mitchell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Michael D Swartz
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX, USA
| | - Angela E Scheuerle
- Department of Pediatrics, Division of Genetics and Metabolism, 49219University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Daryl A Scott
- Department of Molecular and Human Genetics, 3989Baylor College of Medicine, Houston, TX, USA.,Department of Molecular Physiology and Biophysics, 3989Baylor College of Medicine, Houston, TX, USA
| | - Hope Northrup
- Department of Pediatrics, Division of Medical Genetics, McGovern Medical School, 8193University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Christian P Schaaf
- Department of Molecular and Human Genetics, 3989Baylor College of Medicine, Houston, TX, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,Heidelberg University, Institute of Human Genetics, Heidelberg, Germany
| | - Joseph W Ray
- Department of Pediatrics, Division of Medical Genetics and Metabolism, University of Texas Medical Branch, Galveston, TX, USA
| | - Scott D McLean
- Clinical Genetics Section, The Children's Hospital of San Antonio, San Antonio, TX, USA
| | - Han Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA.,Center for Precision Health, UTHealth School of Public Health and UTHealth School of Biomedical Informatics, Houston, TX, USA
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
| | - A J Agopian
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
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Orofacial clefts associated with cardiac anomalies. SCIENTIA MEDICA 2021. [DOI: 10.15448/1980-6108.2021.1.37355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIMS: Orofacial clefts (OFC) are a heterogeneous group of birth defects arising in about 1.7/1000 newborns. They can occur with other congenital anomalies, including heart defects. We aim to describe a population with orofacial clefts and associated cardiac anomalies.METHODS: Retrospective study of patients attended in the Cleft Lip and Palate Multidisciplinary Group outpatient clinic at Hospital Universitario São João, Porto-Portugal. Medical records from January 1992 through December 2018 were reviewed. Patients were divided into four groups according to the Spina classification: cleft lip (CL), cleft lip and palate (CLP), isolated cleft palate (CP) and atypical cleft (AC). Further categorization included gender, affected relatives, associated congenital anomalies and syndromes.RESULTS: From the 588 patients included, 77 (13%) presented cardiac anomalies. Of those with orofacial cleft and cardiac anomalies, 53% were males and 17% had known affected relatives. CP was the most common cleft among patients with cardiac anomaly (~56%). Additional congenital anomalies were found in 89.7% of patients, namely facial defects, central nervous system, renal and skeletal malformations. A recognizable syndrome was identified in 61.5%, being Pierre-Robin the most common (n=22), followed by 22q11.2 microdeletion (n=9). Both additional congenital anomalies and recognizable syndromes were significantly more prevalent in patients with heart disease (p<0.05). The main groups of cardiac anomalies were left-to-right shunt (n=47) and right ventricular outflow tract obstruction (n=14). From these, 26 had a ventricular septal defect, 15 atrial septal defect and seven patients had tetralogy of Fallot. Five patients had dysrhythmias.CONCLUSIONS: Due to the high prevalence of cardiac anomalies in the cleft population, a routine cardiac evaluation should be performed in all these patients.
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Cano ML, Solano N, López J, Fox M, Sarmientos L, Álvarez B. A retrospective study of the epidemiological characteristics of patients with orofacial clefts: Craniofacial anomalies unit of the University Hospital of Maracaibo. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2020. [DOI: 10.4103/jclpca.jclpca_26_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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AlHammad Z, Suliman I, Alotaibi S, Alnofaie H, Alsaadi W, Alhusseini S, Aldakheel G, Alsubaie N. The prevalence of non-syndromic orofacial clefts and associated congenital heart diseases of a tertiary hospital in Riyadh, Saudi Arabia. Saudi Dent J 2019; 33:137-142. [PMID: 33679106 PMCID: PMC7910677 DOI: 10.1016/j.sdentj.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/03/2022] Open
Abstract
Background Orofacial clefts are considered one of the most common birth defects and are frequently associated with other malformations. Congenital heart disease is one of the most prevalent congenital malformation. Objective To investigate the prevalence of congenital heart diseases associated with non-syndromic orofacial clefts in the Saudi population. Methods Electronic files of non-syndromic orofacial cleft patients who visited the Oral and Maxillofacial Surgery Department in King Abdulaziz Medical City of Riyadh, Saudi Arabia from January 2015 to December 2018 were retrospectively reviewed. Data were recorded in an excel sheet and analyzed using SPSS via frequency tests. Results In the cleft children identified, the prevalence of non-syndromic orofacial clefts was (77%). Orofacial clefts showed a male predominance (62%). The most common orofacial phenotype was unilateral cleft lip and palate (34%). The prevalence of associated congenital malformations with orofacial clefts was (41%). The most prevalent congenital malformation was congenital heart disease (35%), mainly found in unilateral cleft lip and palate patients (33%). The prevalence of associated congenital heart disease with orofacial clefts was (19%). The most frequent type of congenital heart disease was atrial septal defect (37%). Conclusion This study highlights the recognition of the associated congenital heart disease with non-syndromic orofacial cleft patients. Global screening protocols designed for newborns with non-syndromic orofacial cleft are needed to eliminate late diagnosis of critical congenital heart diseases which might present operative risks of anesthesia and/or surgical procedures.
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Key Words
- ASD, atrial septal defect
- AVS, aortic valve stenosis
- CHD, congenital heart disease
- CL, cleft lip
- CLP, cleft lip and palate
- CP, cleft palate
- Cleft lip and palate
- Congenital heart disease
- MVP, mitral valve prolapse
- Non-syndromic
- OFC, orofacial cleft
- Orofacial cleft
- PVS, pulmonary valve stenosis
- Prevalence
- Saudi Arabia
- TGA, transposition of great arteries
- VSD, ventricular septal defect
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Affiliation(s)
- Ziyad AlHammad
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Ihab Suliman
- Department of Cardiac Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sami Alotaibi
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Hourya Alnofaie
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia.,Division of Oral and Maxillofacial Surgery, Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Waad Alsaadi
- Pediatric Dentistry and Orthodontic Department, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alhusseini
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghadah Aldakheel
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Noura Alsubaie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Jayarajan R, Vasudevan P. A comprehensive review of orofacial cleft patients at a university hospital genetic department in the UK. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2019. [DOI: 10.4103/jclpca.jclpca_4_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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