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Epidemiologic Trends of Cleft Lip and Palate in a Southern State: A 30-Year Follow-Up
Madyson I Brown1, Martin G McCandless1, Samuel J Hopper1
1From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson.
Insights
Orofacial cleft (OFC) incidence in Mississippi has decreased overall since historical data, with changing regional patterns observed. Rates increased in non-White infants but decreased statewide, suggesting potential shifts in risk factors or access to care.
Area of Science:
- Pediatric Medicine
- Craniofacial Surgery
- Public Health Epidemiology
Background:
- Children's of Mississippi is the sole American Cleft Palate-Craniofacial Association-approved cleft team in the state.
- Limited data exists on geographic and demographic patterns of orofacial cleft (OFC) patients treated at this center.
Purpose of the Study:
- To analyze geographic and demographic trends of orofacial cleft (OFC) patients treated at Children's of Mississippi from 2015 to 2020.
- To compare current OFC incidence with historical data and examine regional variations within Mississippi.
Main Methods:
- Retrospective analysis of 184 OFC patients treated between 2015-2020.
- Demographic data, including birth county and live births, were collected and analyzed.
- Incidence rates were compared across Mississippi public health regions using ANOVA and contrasted with historical 1980-1989 data.
Main Results:
- Statewide OFC incidence was 0.83 per 1000 live births (n=222,819).
- Incidence rates were similar for White (0.83/1000) and non-White (0.82/1000) infants, contrasting with historical data (1.36 and 0.54, respectively).
- Significantly lower OFC incidence was found in the northern region (0.25/1000) compared to central (1.21/1000) and southern (0.86/1000) regions.
Conclusions:
- Current OFC incidence in Mississippi has decreased compared to historical rates, despite an increase among non-White infants.
- Observed regional disparities in OFC incidence may indicate actual pattern changes, proximity to the treatment center, or access to care issues.
- Further research is needed to elucidate regional risk factors and access to cleft care across Mississippi.
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.
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