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      Factores de riesgo en pacientes con fisura de labio y paladar en México. Estudio en 209 pacientes Translated title: Risk factors associated with cleft lip and palate in Mexico. A 209 patient analysis

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          Abstract

          Resumen Introducción y objetivo. El labio hendido (con o sin paladar hendido asociado) y el paladar hendido aislado afectan a 1 de cada 600 recién nacidos en el mundo. Su etiología es multifactorial e intervienen factores de medioambiente, sociodemográficos y genéticos. El objetivo del presente estudio es establecer una relación entre los distintos tipos de fisuras labio-palatinas y diversos factores de riesgo asociados a su prevalencia en México. Material y método. Estudiamos 209 pacientes de diferentes edades con diagnóstico de labio y paladar hendido, atendidos en hospitales generales públicos y privados de las regiones del norte, centro y sur de la república mexicana. Obtuvimos los datos de los pacientes a través de entrevistas a madres o tutores en los menores de edad y por entrevista directa a los mayores de edad. Resultados. El 47.8% fueron mujeres. La edad promedio fue de 8.9 ± 7.3 años. Del total, 163 (78%) tenían diagnóstico de fisura labio-palatina, y 46 (22%) de fisura de labio o paladar aislados. La edad de la madre al momento del embarazo infuyó en la mayor prevalencia de la fisura labio-palatina. Los antecedentes familiares de fisuras labio-palatinas también determinaron mayor porcentaje de pacientes con labio + paladar hendido que con el padecimiento aislado (41.1% frente a 26.1% respectivamente). Conclusiones. Consideramos que, dado que la edad de la madre al momento del embarazo es un factor directamente asociado a la prevalencia de la fisura labio-palatina, los estudios derivados de Salud Pública son fundamentales, particularmente aquellos que tratan sobre el embarazo de alto riesgo (madre adolescente y madre de edad avanzada).

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          Abstract Background and objective. Cleft lip and palate are associated with several factors including demographic and genetic factors among others. The estimated prevalence of the disease is 1-600 worldwide. Our aim is to study the relationship between the prevalence of cleft lip and palate and several factors associated to the disease in Mexico. Methods. A total of 209 patients with cleft lip and palate (isolated or combined) were included. Patients were referred from both public and private hospitals. Data were collected through direct interview and questionnaire with patientes´ mother or parent. Results. In our study, 47.8% patients were female. Mean age was 8.9 ± 7.3 years old; 163 patients (78%) had a combined cleft-lip and palate, and 46 (22%) had an isolated cleft lip or palate. Mother´s age was directly associated with the prevalence of cleft lip and palate. The history of facial clefts in the family was also directly related to the presence of a combined cleft, in contrast to an isolated cleft. (41.1% vs 26.1% respectively). Conclusions. In our study, both cleft lip and palate were directly related to the age of the mother. Thus, we believe that future studies should address the importance of preventive measures and treatment in the woman with a high-risk pregnancy (such as adolescent teens with pregnancy and elderly women).

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          Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies

          Background Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. Methods We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. Results The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently. The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB) exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. Conclusions The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes.
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            Maternal Age, Parity and Isolated Birth Defects: A Population-Based Case-Control Study in Shenzhen, China

            Background The etiology of birth defects has been widely studied but is not yet fully clarified, previously published data had suggested that maternal age or parity maybe involved, but without consistent conclusions. Methods A population-based, case-control study was nested in a cohort of perinatal infants born from 2010 to 2012 in Baoan District, Shenzhen. Four categories of isolated birth defects were defined as cases: congenital heart defects (CHD, n = 693), polydactyly (n = 352), cleft lip with or without palate (CL/P, n = 159) and equinovarus (n = 119). Controls were non-malformed infants (n = 11,307) randomly selected from the same area and period. Odds ratios (ORs) and the 95% confidence intervals (CIs) were computed by multivariable unconditional logistic regression analysis. Results Young maternal age (<25 years old) was associated with a reduced risk of CHD (adjusted OR = 0.73, 95% CI 0.59–0.90), while with an elevated risk of polydactyly (adjusted OR = 1.42, 95% CI 1.09-1.84). Increased risk of CL/P-affected pregnancy was observed in mothers older than 35 years old (adjusted OR = 2.12, 95% CI 1.26–3.57). Compared to primipara, those having their second, and third or more delivery were less likely to have infants with equinovarus, with significant adjusted ORs of 0.59 (0.40–0.89) and 0.42 (0.19–0.93), respectively. Conclusion Maternal age was significantly associated with CHD, polydactyly and CL/P relevant pregnancy. Mothers with higher parity might have lower risk of equinovarus occurrence in offsprings.
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              Risk factors and comorbidities in Brazilian patients with orofacial clefts

              Abstract: Considering that environmental risk factors substantially contribute to the etiology of orofacial clefts and that knowledge about the characteristics and comorbidities associated with oral clefts is fundamental to promoting better quality of life, this study aimed to describe the risk factors, main characteristics, and comorbidities of a group of patients with cleft lip and/or cleft palate (CL/P) from Rio Grande do Norte (RN), Brazil. Data were obtained from 173 patients with CL/P using a form from the Brazilian database on Orofacial Clefts. Most patients were male with cleft lip and palate and had a normal size and weight at birth; presented few neonatal intercurrent events; and had anemia and respiratory and cardiovascular diseases as main associated comorbidities. They also required timely surgical rehabilitation and multidisciplinary care to stimulate their neuropsychomotor development. In addition, a high frequency of familial recurrence and of parental consanguinity was evidenced in the studied population, especially for the cleft lip and cleft palate type. Other relevant findings were the considerable maternal exposure to alcohol, infections, smoking, and hypertension, as well as low supplementation with vitamins and minerals and deliberate consumption of analgesics, antibiotics, and antihypertensives during pregnancy. Characterization of the CL/P patient profile is essential for the planning of health services and integration among the health professionals involved in the diagnosis and treatment of these malformations. Our results reinforce the need for additional research to confirm the association between environmental factors and the development of orofacial clefts.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                December 2021
                : 47
                : 4
                : 389-394
                Affiliations
                [4] Ciudad de México orgnameInstituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" (INCMNSZ) orgdiv1Unidad de Medicina Genómica México
                [3] Ciudad de México orgnameHospital Infantil de México "Federico Gómez" orgdiv1Servicio de Epidemiología Clínica México
                [5] Puebla orgnameHospital Ángeles Puebla orgdiv1Departamento de Cirugía Plástica y Reconstructiva México
                [2] Ciudad de México orgnameInstituto Mexicano del Seguro Social (IMSS) orgdiv1Departamento de Epidemiología Clínica México
                [1] Ciudad de México orgnameFundación Mexicana para Niños con Labio y Paladar Hendido AC México
                Article
                S0376-78922021000400389 S0376-7892(21)04700400389
                10.4321/s0376-78922021000400009
                e8284575-63fe-49be-ac85-241c9581276a

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 15 November 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 6
                Product

                SciELO Spain

                Categories
                Reconstructiva

                Clef lip,Clef palate,Clef lip-palate,Labio hendido,Paladar hendido,Fisuras labio-palatinas

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