1
|
Brown MI, McCandless MG, Hopper SJ, Lucas ED, Corder BN, Galarza LI, Hoppe IC, Humphries LS. Epidemiologic Trends of Cleft Lip and Palate in a Southern State: A 30-Year Follow-Up. South Med J 2024; 117:316-322. [PMID: 38830585 DOI: 10.14423/smj.0000000000001698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Children's of Mississippi at the University of Mississippi Medical Center serves as the state's only American Cleft Palate-Craniofacial Association-approved cleft team at the only pediatric hospital in the state. The goal of this study is to report geographic and demographic patterns of patients with orofacial cleft (OFC) treated at Children's of Mississippi, which are lacking. METHODS Patients with OFC treated at Children's of Mississippi from 2015 to 2020 were included. Demographic data were collected, including birth county and total live births from state data. Significant differences between incidence of OFC among public health regions of Mississippi were examined using analysis of variance (P < 0.05). Cases were compared with historical data from 1980 to 1989. RESULTS There were 184 patients who presented with OFC, with a statewide incidence of 0.83 per 1000 live births among 222,819 live births in the state across 6 years. The incidence of OFC was 0.83/1000 for Whites and 0.82/1000 for non-Whites versus a historical rate of 1.36 and 0.54, respectively. Significantly fewer children in the northern region (0.25/1000) were born with OFC than in central (1.21; P < 0.001) and southern (0.86; P < 0.001) regions. CONCLUSIONS Results from this study suggest changing regional patterns of OFC in Mississippi. Although rates increased among non-White infants, the overall incidence of OFC has decreased compared with historical data. The findings may reflect actual incidence patterns in the state or the proximity of certain regions to Children's of Mississippi. Further study may reveal regional differences in risk factors underlying OFC incidence, and/or issues with access to cleft care for different regions in the state.
Collapse
Affiliation(s)
- Madyson I Brown
- From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson
| | - Martin G McCandless
- From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson
| | - Samuel J Hopper
- From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson
| | - Eric D Lucas
- From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson
| | - Brittany N Corder
- From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson
| | | | | | | |
Collapse
|
2
|
Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother–Infant Dyads With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2019; 57:477-486. [DOI: 10.1177/1055665619878972] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To examine trends in breast milk provision and to characterize the breast milk feeding practices experienced by mother–infant dyads with cleft lip and/or palate (CL/P) in a large US sample. Design: Cross-sectional study. Methods: An online survey was distributed through cleft-related social media sites in the United States and in a single cleft lip and palate clinic. Statistical analyses included Kruskal-Wallis H tests and post hoc Mann-Whitney tests to examine group differences based on cleft type and prenatal versus postnatal cleft diagnosis. Linear regression was used to estimate associations between obtained variables. Participants: One hundred fifty biological mothers of infants (8-14 months of age) with CL/P (15% cleft lip, 29% cleft palate, 56% cleft lip and palate). Results: Forty-six percent of mothers of infants with CL/P provided breast milk to their infant for at least 6 months. Five percent of infants ever fed at breast, and 43% received pumped breast milk via bottle. The most commonly reported supports included lactation consultants, nurses, feeding therapists, and online support groups. Feeding therapy was received by 48% of infants. Conclusions: A lower percentage of mothers of infants with CL/P reported providing breast milk compared to national estimates of the general population of infants without clefting. Results suggested there are multiple barriers, as well as numerous medical and psychosocial supports that facilitated breast milk feeding success. Implications for care are discussed.
Collapse
Affiliation(s)
- Lauren L. Madhoun
- Division of Clinical Therapies, Nationwide Children’s Hospital, Columbus, OH, USA
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
| | - Canice E. Crerand
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Sarah Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Adriane L. Baylis
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
3
|
|
4
|
Parental health and social support in the first trimester of pregnancy and the risk of oral clefts: a questionnaire-based, case-control study. Plast Reconstr Surg 2015; 135:212-218. [PMID: 25539307 DOI: 10.1097/prs.0000000000000778] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonsyndromic oral clefts are complex in cause and have multiple genetic and environmental risk factors. This retrospective, questionnaire-based, case-control study investigated the relationship between oral clefts and parental mental and physical health and social support. METHODS Three hundred forty-seven parents of children with nonsyndromic oral clefts and 420 controls were included. Maternal and paternal health during the first trimester was assessed using interviews and questionnaires modeled from the Cornell Medical Index and the Social Support Rating Scale. Case-control analyses were performed using t tests, chi-square tests, and logistic regression. RESULTS Parental age, household income, and subsisting on farming were significantly different for cases and controls. The Cornell Medical Index for cases was significantly worse compared with controls for physical and psychological health. Logistic regression showed that nine factors were significantly associated with oral clefts: paternal respiratory health (OR, 1.56; p = 0.03), maternal gastrointestinal health (OR, 1.71; p < 0.01), maternal musculoskeletal health (OR, 1.50; p < 0.01), paternal nervous system health (OR, 2.82; p < 0.01), maternal frequency of illness (OR, 2.21; p = 0.01), maternal diseases (OR, 2.44; p < 0.01), maternal health habits (OR, 1.73; p < 0.01), paternal feelings of inadequacy (OR, 2.28; p = 0.03), and maternal anger (OR, 2.28; p < 0.01) in the first trimester. Weaker social support from the community was associated with oral clefts (p < 0.01). CONCLUSION Maternal and paternal health and social support may affect a family's risk of having a child with a cleft. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
Collapse
|
5
|
Uchiyama T, Yamashita Y, Susami T, Kochi S, Suzuki S, Takagi R, Tachimura T, Nakano Y, Shibui T, Michi KI, Nishio J, Hata Y. Primary Treatment for Cleft Lip and/or Cleft Palate in Children in Japan. Cleft Palate Craniofac J 2012; 49:291-8. [DOI: 10.1597/09-155] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate current trends in primary treatment for children with cleft lip and/or cleft palate in Japan. Design Nationwide, retrospective study under the direction of the Academic Survey Committee of the Japanese Cleft Palate Association based on analysis of data obtained via a booklet-style questionnaire completed by institutions providing primary treatment for cleft lip and/or palate patients. Participants, Patients Patients were 4349 children undergoing primary repair for cleft lip and/or palate at 107 participating institutions between 1996 and 2000. Main Outcome Measure(s) Cleft type, laterality; use of infant palatal plate; and timing and technique of primary repair for cleft lip and/or palate were evaluated by cleft surgeons at 107 participating institutions. Results Of a total of 2874 patients with cleft lip and palate or cleft palate only, infant palatal plates were used with 1087 (37.8%) and were not used with 1787 (62.2%). Primary unilateral lip repair was performed at the age of 2 to 6 months in more than 90% of patients. Bilateral cleft lip was treated by one-stage repair in 285 patients (44.5%) and by two-stage repair in 258 (40.2%). Primary one-stage palatal repair was performed in 2212 (76.9%) and two-stage palatal repair in 262 (9.1%) cleft palate patients. Information on treatment of the remaining 400 (14%) patients was unavailable. Conclusion This investigation clarified current trends in primary treatment for cleft lip and/or palate in Japan. The results suggest the need for an increase in regional core hospitals and greater variation in treatment options.
Collapse
Affiliation(s)
- Takeshi Uchiyama
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan
| | - Yukari Yamashita
- Department of Oral Rehabilitation, School of Dentistry, Showa University, Tokyo, Japan
| | - Takafumi Susami
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
| | - Shoko Kochi
- Clinics for Maxillo-Oral Disorders, Tohoku University Hospital Dental Center, Miyagi, Japan
| | - Shigehiko Suzuki
- Department of Plastic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery, Niigata University Graduate, School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Tachimura
- Osaka University Graduate School of Dentistry, Division of Functional Oral Neuroscience, Osaka, Japan
| | | | - Takeo Shibui
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan
| | | | - Juntaro Nishio
- Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yuiro Hata
- Division of Maxillofacial/Neck Reconstruction, Department of Head and Neck Reconstruction, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
6
|
Payakachat N, Tilford JM, Brouwer WB, van Exel NJ, Grosse SD. Measuring health and well-being effects in family caregivers of children with craniofacial malformations. Qual Life Res 2011; 20:1487-95. [PMID: 21347570 DOI: 10.1007/s11136-011-9870-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2011] [Indexed: 11/25/2022]
Abstract
PURPOSE This research explores the sensitivity of three generic instruments for preference-weighting health states of family caregivers of children with craniofacial malformations (CFM). We also examine the construct validity of the new CarerQol instrument measuring caregiver burden and general quality of life. METHODS Caregivers of children born with CFM were identified through the Arkansas Reproductive Health Monitoring System. A mailed survey included the HUI3, the SF-6D, the QWB-SA to measure health-related quality of life; the CES-D measuring depressive symptoms as well as the SRB scale, and the CarerQol. The HUI3, the SF-6D, and the QWB-SA were examined in relation to the CES-D the SRB, the CarerQol, and each other. RESULTS A total of 65 (63%) parents of children (≤17 years) responded. The mean SF-6D, HUI3, and QWB-SA scores were 0.81 (SD = 0.13), 0.84 (SD = 0.23), and 0.67 (SD = 0.14), respectively. The mean CES-D score was 13.3 (SD = 13.4) and 28.6% of the sample met a threshold for depressive symptoms (CES-D ≥ 16). The mean CarerQol-VAS and SRB scores were 7.5 (SD = 2.3) and 15.1 (SD = 23.5), respectively. The Spearman correlations (ρ) of the HUI3 and the SF-6D with the CES-D were similar (-0.81 and -0.76) while the ρ was lower (-0.57) for the QWB-SA. Preference-weighted scores of caregivers with CES-D scores ≥ 16 differed significantly for both the SF-6D and the HUI3, but not the QWB-SA. All three generic instruments showed moderate to strong relationships with the CarerQol. CONCLUSIONS The HUI3 and SF-6D were more sensitive predictors of depressive symptoms in this caregiver sample than was the QWB-SA. The CarerQol showed good construct validity and may be useful for measuring well-being effects associated with caregiving.
Collapse
Affiliation(s)
- Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W. Markham St., #522, Little Rock, AR 72205, USA.
| | | | | | | | | |
Collapse
|