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Higher maternal age is associated with higher occurrence of cleft lip/palate in neonates under intensive care


Cleft palate
Congenital abnormalities
Infant, newborn
Intensive care, neonatal

How to Cite

Maurique L de S, Muniz FWMG, Silveira NPV, Camassola M, Oliveira BM de. Higher maternal age is associated with higher occurrence of cleft lip/palate in neonates under intensive care. Braz. J. Oral Sci. [Internet]. 2022 Nov. 3 [cited 2024 Apr. 16];22(00):e239246. Available from:


Aim: To assess the prevalence of cleft lip and/or cleft palate (CL/P) and associated variables in neonates admitted to neonatal intensive care units (ICU). Methods: Medical charts for neonates born and admitted to the ICU between 2012 and 2018 were reviewed. Obstetric and neonatal variables were collected by a trained researcher. In the case group, all neonates with CL/P were included. The control group was formed by matching sex, prematurity and month of birth using random number generation. Neonates with congenital malformations were excluded from the control group. Adjusted logistic regression was used (p<0.05). Results: The prevalence of CL/P was 0.43% (n=15). Five cases were excluded, as pairing was not possible. Twenty neonates were included in the control group. In the final multivariate model, CL/P was only associated with increased maternal age. For each year of increase in maternal age, neonates had a 35.2% higher chance of presenting CL/P (95% confidence interval: 1.021–1.792). Conclusions: Higher maternal age was associated with higher occurrence of CL/P in neonates admitted to the ICU. No other neonatal or maternal independent variables were associated with CL/P. Due to missing data, interpretation of study results must be approached with caution.


Candotto V, Oberti L, Gabrione F, Greco G, Rossi D, Romano M, et al. Current concepts on cleft lip and palate etiology. J Biol Regul Homeost Agents. 2019 May-Jun;33(3 Suppl 1):145-51.

Kang SL, Narayanan CS, Kelsall W. Mortality among infants born with orofacial clefts in a single cleft network. Cleft Palate Craniofac J. 2012 Jul;49(4):508-11. doi: 10.1597/10-179.

Giang HTN, Bechtold-Dalla Pozza S, Ulrich S, Linh LK, Tran HT. Prevalence and pattern of congenital anomalies in a Tertiary Hospital in Central Vietnam. J Trop Pediatr. 2020 Apr;66(2):187-93. doi: 10.1093/tropej/fmz050.

Charan pal A, Mukhopadhyay DK, Deoghuria D, Mandol SK, Patra AC, Murmu S. Prevalence of congenital malformations in newborns delivered in a Rural Medical College Hospital, West Bengal. J Dent Med Sci. 2015 Dec;14(12):26-32. doi: 10.9790/0853-141222632.

Lehtonen L, Gimeno A, Parra-Llorca A, Vento M. Early neonatal death: A challenge worldwide. Semin Fetal Neonatal Med. 2017 Jun;22(3):153-60. doi: 10.1016/j.siny.2017.02.006.

Worley ML, Patel KG, Kilpatrick LA. Cleft lip and palate. Clin Perinatol. 2018 Dec;45(4):661-78. doi: 10.1016/j.clp.2018.07.006.

Dao AM, Goudy SL. Cleft palate repair, gingivoperiosteoplasty, and alveolar bone grafting. Facial Plast Surg Clin North Am. 2016 Nov;24(4):467-76. doi: 10.1016/j.fsc.2016.06.005.

Matute J, Lydick EA, Torres OR, Owen KK, Jacobsen KH. Prevalence of cleft lip and cleft palate in rural north-central guatemala. Cleft Palate Craniofac J. 2015 May;52(3):377-80. doi: 10.1597/13-347.

Paaske EB, Garne E. Epidemiology of orofacial clefts in a Danish county over 35 years - Before and after implementation of a prenatal screening programme for congenital anomalies. Eur J Med Genet. 2018 Sep;61(9):489-92. doi: 10.1016/j.ejmg.2018.05.016.

Hubbard BA, Baker CL, Muzaffar AR. Prenatal counseling's effect on rates of neonatal intensive care admission for feeding problems cleft lip/palate infants. Mo Med. 2012 Mar-Apr;109(2):153-6.

Christensen K. The 20th century Danish facial cleft population--epidemiological and genetic-epidemiological studies. Cleft Palate Craniofac J. 1999 Mar;36(2):96-104. doi: 10.1597/1545-1569_1999_036_0096_tcdfcp_2.3.co_2.

Bille C, Knudsen LB, Christensen K. Changing lifestyles and oral clefts occurrence in Denmark. Cleft Palate Craniofac J. 2005 May;42(3):255-9. doi: 10.1597/03-139.1.

Schutte BC, Murray JC. The many faces and factors of orofacial clefts. Hum Mol Genet. 1999;8(10):1853-9. doi: 10.1093/hmg/8.10.1853.

Mbuyi-Musanzayi S, Kayembe TJ, Kashal MK, Lukusa PT, Kalenga PM, Tshilombo FK, et al. Non-syndromic cleft lip and/or cleft palate: Epidemiology and risk factors in Lubumbashi (DR Congo), a case-control study. J Craniomaxillofac Surg. 2018 Jul;46(7):1051-8. doi: 10.1016/j.jcms.2018.05.006.

Koga H, Iida K, Maeda T, Takahashi M, Fukushima N, Goshi T. Epidemiologic research on malformations associated with cleft lip and cleft palate in Japan. PLoS One. 2016 Feb 22;11(2):e0149773. doi: 10.1371/journal.pone.0149773.

ECLAMC. Latin American Collaborative Study of Congenital Malformations. Atlas of birth. 2020 [cited 2020 Sep 21]. Available fotmt:

World Health Organization. Application tools. 2020 [cited 2020 Sep 21]. Available from:

Shibukawa BMC, Rissi GP, Higarashi IH, oliveira RR. Factors associated with the presence of cleft lip and/or cleft palate in Brazilian newborns. Rev Bras Saude Mater Infant. 2019 Sep-Dec;19(4):947-56.

Cassinelli A, Pauselli N, Piola A, et al. National Health Care Network for children with oral clefts: organization, functioning, and preliminary outcomes. Arch Argent Pediatr 2018 Feb;116(1):e26-33. doi: 10.5546/aap.2018.eng.e26.

de Souza S, Nampo FK, Pestana CR. Major birth defects in the Brazilian side of the triple border: a population-based cross-sectional study. Arch Public Health. 2020 Jun 30;78:61. doi: 10.1186/s13690-020-00443-w.

de Bérail A, Lauwers F, Noirrit Esclassan E, Woisard Bassols V, Gardini B, Galinier P. [Epidemiology of malformations associated with cleft lip and palate: a retrospective study of 324 cases]. Arch Pediatr. 2015 Aug;22(8):816-21. French. doi: 10.1016/j.arcped.2015.05.005.

Munabi NCO, Swanson J, Auslander A, Sanchez-Lara PA, Davidson Ward SL, Magee WP 3rd. The prevalence of congenital heart disease in nonsyndromic cleft lip and/or palate: a systematic review of the literature. Ann Plast Surg. 2017 Aug;79(2):214-20. doi: 10.1097/SAP.0000000000001069.

Desalew A, Sintayehu Y, Teferi N, Amare F, Geda B, Worku T, et al. Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units of public hospitals in eastern Ethiopia: a facility-based prospective follow-up study. BMC Pediatr. 2020 Apr;20(1):160. doi: 10.1186/s12887-020-02051-7.

Malic CC, Lam M, Donelle J, Richard L, Vigod SN, Benchimol EI. incidence, risk factors, and mortality associated with orofacial cleft among children in Ontario, Canada. JAMA Netw Open. 2020 Feb;3(2):e1921036. doi: 10.1001/jamanetworkopen.2019.21036.

Berg E, Lie RT, Sivertsen Å, Haaland ØA. Parental age and the risk of isolated cleft lip: a registry-based study. Ann Epidemiol. 2015 Dec;25(12):942-7.e1. doi: 10.1016/j.annepidem.2015.05.003.

Davanzo R, Antonio C, Pulella A, Lincetto O, Schierano S. Neonatal and post-neonatal onset of early congenital syphilis: a report from Mozambique. Ann Trop Paediatr. 1992;12(4):445-50. doi: 10.1080/02724936.1992.11747612.

Voordouw B, Rockx B, Jaenisch T, Fraaij P, Mayaud P, Vossen A, et al. Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev. 2019 Dec;33(1):e00130-18. doi: 10.1128/CMR.00130-18.

Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014 Sep;384(9946):857-68. doi: 10.1016/S0140-6736(14)60932-6.

Pereira-da-Silva L. Neonatal anthropometry: a tool to evaluate the nutritional status and predict early and late risks. In: The handbook of anthropometry: physical measures of human form in health and disease. New York: Springer; 2012. p.1079-104.

Brazil. DataSUS; 2020 [cited 2020 Sep 21]. Available from:

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Copyright (c) 2022 Luísa de Souza Maurique, Francisco Wilker Mustafa Gomes Muniz, Nathalia Preissler Vaz Silveira, Melissa Camassola, Bibiana Mello de Oliveira


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