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Health and Socioeconomic Predictors of 13,546 Clefts in a Population-Based Analysis
Kiersten C. Woodyard, MPH. Douglas Dembinski MD. Sydni Meunier MD. Kelly Spiller MD. Brian S. Pan MD.
University of Cincinnati College of Medicine
2023-02-10
Presenter: Kiersten C. Woodyard
Affidavit:
Kiersten is responsible for the conception of this project and it's completion. Kiersten is not a resident in our training program however, she is a medical student.
Director Name: Ann R. Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Cleft lip and palate remain among the most prevalent congenital anomalies. A contemporary analysis of cleft epidemiology was conducted to examine trends in health and socioeconomic indices associated with the birth prevalence of clefts in the United States.
Methods:
Population-based data was extracted using the CDC Wide-ranging ONline Data for Epidemiologic Research (WONDER) database. 19 million births from 2016-2020 were examined, data collection included parental demographics, health conditions, and congenital anomalies. Data was available for patients with Cleft Palate Only (CPO) and Cleft Lip with/without Cleft Palate (CLąP). Odds Ratio was used to compare patients with CPO and CLąP to patients without either condition.
Results:
9078 patients with CLąP and 4468 patients with CPO were born between 2016-2020. Approximately 18.95 million infants were born without a cleft condition. Parental education of Bachelor's Degree or higher demonstrated protection against CLąP and CPO, though lower rates of education were associated only with increased risk for CLąP. WIC recipients and Medicaid recipients had increased risk for both CLąP and CPO. Pre-pregnancy diabetes, pre-pregnancy hypertension, tobacco use, and obesity were associated with increased risk for CLąP and CPO. Maternal Hepatitis C was 4 times more likely in CPO and 1.5 times more likely in CLąP.
Conclusions:
Analysis of US birth data demonstrated that clefts are increasingly associated with predictors of low socioeconomic status, such as WIC, Medicaid recipient status, and parental education. Further investigation is needed examining the association between clefts, socioeconomic indices, and health conditions prevalent in vulnerable populations.
