American Journal of Epidemiology Advance Access originally published online on August 2, 2005
American Journal of Epidemiology 2005 162(5):448-453; doi:10.1093/aje/kwi214
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ORIGINAL CONTRIBUTIONS |
Cleft Lip and Palate versus Cleft Lip Only: Are They Distinct Defects?
1 Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC
2 Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC
3 Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
4 Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
5 Department of Plastic Surgery, Haukeland University Hospital, Bergen, Norway
6 Department of Plastic Surgery, The National Hospital, Oslo, Norway
Correspondence to Emily W. Harville, Department of Epidemiology, University of North Carolina, CB #7435, Chapel Hill, NC 27599-7435 (e-mail: ewh{at}unc.edu).
Cleft lip defects are usually regarded as a single entity, with the assumption that an accompanying cleft palate represents the more severe form. The authors linked data from the Medical Birth Registry of Norway with medical records from two centralized centers to provide a population-based data set. They assessed the distribution of cleft lip only and cleft lip with cleft palate by covariate. Among 1.8 million Norwegian livebirths between 1967 and 1998, there were 1,572 cases of cleft lip with cleft palate and 1,122 cases with cleft lip only. Seventeen percent of those with cleft lip and palate had another defect compared with 9% of those with cleft lip only. For boys, the risk was greater for cleft lip and palate than for cleft lip only (odds ratio = 2.4 vs. 1.8, p < 0.001 for difference). The risk of cleft lip only, but not of cleft lip and palate, was increased for twins (odds ratio = 1.6 vs. 1.1, p = 0.11) and infants whose parents were first cousins (odds ratio = 2.7 vs. 0.7, p = 0.07). Although cleft lip with cleft palate may simply represent a more severe form of the defect, epidemiologic assessments of cleft lip should, when possible, include separate analyses of these two groups.
abnormalities; cleft lip; cleft palate; Norway
Abbreviations: CLO, cleft lip only; CLP, cleft lip and palate; ICD-8, International Classification of Diseases, Eighth Revision
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