Epidemiological features of patients with nonsyndromic cleft lip and/or palate in Western Parana

Aim: : To describe the clinical, demographic and environmental features associated with NSCL/P (nonsyndromic cleft lip and/or palate) patients born in western Parana state, Brazil. Methods: This cross-sectional, observational, retrospective study included 188 patients attended at the Association of Carriers of Cleft Lip and Palate - APOFILAB, Cascavel-Parana, between 2012 and 2014. Information on demographic characteristics, medical and dental histories and life style factors were obtained from records and personal interviews. Results: Among the 188 patients, cleft lip and palate (CLP) was the most frequent subtype (55.8%), followed by cleft lip only (CLO, 25.0%) and cleft palate only (CPO, 19.2%). Caucasian males were the most affected, although no differences among types of cleft were observed. The otorhinolaryngologic and respiratory alterations were the most frequent systemic alterations in NSCL/P patients, and more than 80% of the NSCL/P mothers reported no vitamin supplements during the first trimester of pregnancy. Conclusions: This study revealed that the prevalence of nonsyndromic oral cleft types in this cohort was quite similar to previously reported prevalence rates. Systemic alterations were identified among 23.4% of the patients and patients with CLP were the most affected. History of maternal exposition to environmental factors related to nonsyndromic oral clefts was frequent and most mothers reported no vitamin supplements during the pregnancy. This study highlights the importance of identifying systemic alterations and risk factors associated with NSCL/P in the Brazilian population for planning comprehensive strategies and integrated actions for the development of preventive programs and treatment.

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Study of Cleft Lip and Palate in Kathmandu Model Hospital, Nepal

Orthodontic Journal of Nepal ◽

10.3126/ojn.v9i1.25682 ◽

2019 ◽

Vol 9 (1) ◽

pp. 6-10

Author(s):

Sanzida Khatun

Keyword(s):

Cleft Palate ◽

Congenital Anomalies ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Positive Family History ◽

First Trimester ◽

Associated Anomalies ◽

Cross Sectional ◽

History Of ◽

First Trimester Of Pregnancy

Introduction: Cleft lip and/or palate is a congenitally persistent space affecting orofacial region. It is generally divided into cleft lip (CL), cleft palate (CP) and cleft lip with cleft palate (CLP). The objective of the study was to evaluate distribution of patterns of orofacial clefts according to sex and laterality; predisposing factors and other congenital anomalies associated with cleft lip and/or palate. Materials & Method: A cross-sectional descriptive type of study was carried out using in 268 patients having cleft lip and/or palate. Types of clefts, predominance of sex and laterality, familial history, associated anomalies and drug and disease history of mother were recorded. Result: The results revealed 23.51% CL, 54.85% CLP and 21.64% CP. There were 58.21% males and 41.79% females. Positive family history of cleft was present in 28.0% and associated anomalies were observed in 3.7% of the cleft subjects. Mothers of 6.0% of the total patients were exposed to teratogenic agents during first trimester of pregnancy. Conclusion: It was concluded that among the three types of cleft (CL, CP and CLP), CLP is the most common type. The males are affected more with cleft lip and/or palate than the females. Clefts also have risks of associated congenital anomalies. Exposure to teratogenic agents in first trimester of pregnancy is also associated with orofacial cleft.

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Analysis of the Prevalence and Incidence of Cleft Lip and Palate in Colombia

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619886455 ◽

2019 ◽

Vol 57 (5) ◽

pp. 552-559 ◽

Cited By ~ 2

Author(s):

Rengifo Reina Herney Alonso ◽

Guarnizo Peralta Stefany Brigetty

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Cross Sectional ◽

Oral Clefts ◽

Birth Prevalence ◽

Administrative Records ◽

Live Births ◽

Population Prevalence ◽

The Individual

Objective: To analyze the population prevalence and birth prevalence of oral clefts in Colombia from 2009 to 2017. Methods: A cross-sectional study using information from the National Administrative Records of Colombia. The data came from 2 types of administrative records (Surveillance System and the Individual Registry of Service Provision) and the oral health national survey. Population prevalence and birth prevalence by type of cleft lip and/or cleft (CL/P) ratios were calculated using Poisson distribution for count data and to assess stationary tests on time series (Dickey-Fuller) and (Phillips-Perron) was used. Results: Population prevalence in Colombia was 3.27 per 10 000 inhabitants (95% confidence interval [CI], 3.21-3.32) and birth prevalence was 6.0 per 10 000 live births (95% CI, 5.67-6.35). Bogotá have the highest population prevalence with CL/P. In the analysis of trends for the prevalence proportion by type of clefts in newborn babies with cleft, it was observed that the highest proportion was for babies with CLP. Cleft lip (CL) has increased from 17.4% in 2014 to 34.2% in 2017, cleft palate (CP) has decreased from 32.9% to 20.2%; and CLP changed from 49.6% to 45.5% in the same period. Conclusions: The population prevalence was 3.27 per 10 000 inhabitants. Births prevalence was 6.0 per 10 000 live births, and Orinoquia and Amazonia have higher rates than the national average. The administrative registers are adequate systems to know the behavior of oral clefts. The CL/P had a nonstationary trend during the period 2014 to 2017.

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Fatores de Riscos na Fissura Labiopalatina Não Sindrômica

UNICIÊNCIAS ◽

10.17921/1415-5141.2020v24n1p86-93 ◽

2021 ◽

Vol 24 (1) ◽

pp. 86-93

Author(s):

Carla Meliso Rodrigues Silvestre ◽

Renata Cristina Giroto Ferreira da Silva ◽

Ageo Mario Candido da Silva ◽

Walkiria Shimoya Bittencourt ◽

Yolanda Benedita Abadia Martins de Barros ◽

...

Keyword(s):

Risk Factors ◽

Environmental Factors ◽

Literature Review ◽

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

First Trimester ◽

Human Beings ◽

Factors Associated ◽

Narrative Literature Review

As anomalias craniofaciais representam um grupo amplo de malformações congênitas que afetam uma grande proporção da sociedade mundial. Entre essas se encontram as fissuras de lábio e/ou de palato, anomalia orofacial mais frequente entre os seres humanos que ocasionam problemas estéticos e funcionais nos indivíduos afetados. A etiologia das fissuras labiopalatinas isoladas ou não-sindrômicas é complexa e multifatorial, associadas à fatores hereditários e ambientais. Este estudo teve como objetivo relatar os fatores genéticos e ambientais associados à etiologia desse tipo de malformação, através de uma revisão narrativa de literatura, a partir das bases de dados: PubMed e Scielo. Os descritores utilizados foram: cleft palate AND cleft lip AND etiology AND risk factors. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos nacionais e internacionais acerca da temática da pesquisa. Baseado na revisão de literatura se pode identificar que os fatores ambientais como: fumo, consumo de álcool, consumo de medicamentos, o não uso de suplementação com polivitamínicos e ácido fólico, exposição a agrotóxicos, idade dos genitores podem aumentar a chance de ocorrência das fissuras labiopalatinas. O acompanhamento gestacional durante o primeiro trimestre gestacional se faz necessário, a fim de monitorar os fatores de risco associados com as fissuras labiopalatinas não sindrômicas. Palavras-chave: Fissura Palatina. Fenda Labial. Etiologia. Fatores de Risco. Abstract Craniofacial anomalies represent a broad group of congenital malformations that affect a large proportion of world society. Among them are cleft lip and / or palate, the most frequent orofacial anomaly among human beings that cause aesthetic and functional problems in the affected individuals. The etiology of isolated or non-syndromic cleft lip and palate is complex and multifactorial, associated with hereditary and environmental factors. This study aimed to report the genetic and environmental factors associated with the etiology of this type of malformation through a narrative literature review conducted in October 2020, using the PubMed and Scielo databases. The keywords used were cleft palate AND cleft lip AND etiology AND risk factors. Articles in English and Portuguese published in national and international journals about the research theme were included. Based on the literature review, it can be identified that environmental factors such as smoking, alcohol consumption, medication consumption, the non-use of supplementation with multivitamins and folic acid, exposure to pesticides, age of parents can increase the chance of cleft lip and palate occurrence. Gestational monitoring during the first trimester of pregnancy is necessary in order to monitor the risk factors associated with non-syndromic cleft lip and palate. Keywords: Cleft Palate. Cleft Lip. Etiology. Risk Factors.

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Feeding practices of children aged 0 to 24 months with clefts attending a specialized hospital in Uganda

10.21203/rs.2.16333/v1 ◽

2019 ◽

Author(s):

Maureen Nabatanzi ◽

Gloria Kimuli Seruwagi ◽

Florence Basiimwa Tushemerirwe ◽

David Lubogo

Keyword(s):

Child Nutrition ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Dietary Diversity ◽

Feeding Practices ◽

World Health ◽

Nutrition Status ◽

Cross Sectional ◽

Oral Clefts ◽

Feeding Difficulties

Abstract Background: Appropriate feeding practices are vital for child nutrition. Despite a low incidence of 0.73 in 1000, Ugandan children with oral clefts face feeding difficulties that affect their feeding practices, nutrition status and health.Objective: To determine the feeding practices, techniques and maternal feeding knowledge among children with oral clefts attending Comprehensive Rehabilitative Services of Uganda (CoRSU) HospitalMethods: This survey was part of a cross-sectional study on feeding practices, mothers’ experiences and support. We consecutively sampled 32 mothers of children with oral clefts aged 0 to 24 months attending CoRSU hospital between April and May, 2018. A structured questionnaire collected data on feeding practices, techniques and maternal feeding knowledge. Descriptive statistics were analyzed using SPSS software.Results: Most children (56%) had cleft lip and palate. Early initiation of breastfeeding was 44% and exclusive breastfeeding was 35%. None continued breastfeeding beyond 12 months. Timely introduction of complementary foods was 75%. 58% met the minimum dietary diversity score, 83% met the minimum meal frequency and 33% received a minimum acceptable diet. 75% of the mothers used bottles, cups and spoons in feeding their children. Majority preferred the specialized soft bottle (50%). 28% of the mothers were knowledgeable on the World Health Organization recommended feeding practices. Conclusions: This cleft group had suboptimal feeding practices since none of the children breastfed beyond 12 months and only one third received an acceptable diet. Varied feeding techniques were employed to improve feeding; majority preferred the specialized soft bottle. Most mothers had inadequate knowledge on feeding. There is need to improve the feeding guidance given to mothers of children with oral clefts. Our findings can guide the design of appropriate feeding interventions for this group.

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The Relationship of Exposure to Anesthesia on Outcomes in Children With Isolated Oral Clefts

Journal of Child Neurology ◽

10.1177/0883073816681257 ◽

2016 ◽

Vol 32 (3) ◽

pp. 308-315 ◽

Cited By ~ 7

Author(s):

Amy L. Conrad ◽

Jon W. Goodwin ◽

James Choi ◽

Robert I. Block ◽

Peg Nopoulos

Keyword(s):

Cognitive Functioning ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Retrospective Chart Review ◽

Cross Sectional Study ◽

Cross Sectional ◽

Brain Volumes ◽

Oral Clefts ◽

Record Review ◽

The Relationship

This study evaluated the relationship between exposure to anesthesia and previously identified differences in cognitive functioning, growth, and volumetric brain measures among a sample of children, adolescents, and young adults with isolated oral clefts. Data from a cross-sectional study were combined with a retrospective chart review. Data were obtained for 87 participants with isolated cleft lip and/or palate (55% male), ranging from 7.5 to 27 years old (mean = 15.78, standard deviation = 4.58). Measures of interest included cognitive functioning, growth measures, and brain volumes. Number of surgeries and time under anesthesia were obtained through systematic medical record review. Potential sex and cleft type differences in exposure as well as relationships between anesthesia exposure and outcome measures were evaluated. Participants with isolated cleft lip and palate had more surgeries and were under anesthesia longer. For participants with isolated cleft lip only, more surgeries were correlated to lower verbal IQ and higher frontal lobe volume.

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Nasal Obstruction in Children With Cleft Lip and Palate: Results of a Cross-Sectional Study Utilizing the NOSE Scale

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618772400 ◽

2018 ◽

Vol 56 (2) ◽

pp. 177-186 ◽

Cited By ~ 2

Author(s):

Rosaline S. Zhang ◽

Lawrence O. Lin ◽

Ian C. Hoppe ◽

Oksana A. Jackson ◽

David W. Low ◽

...

Keyword(s):

Nasal Obstruction ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Symptom Evaluation ◽

Significant Difference ◽

History Of ◽

Nasoalveolar Molding

Objective: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. Design: Retrospective cross-sectional study. Setting: Cleft Lip and Palate Program, Children’s Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey. Interventions: Nasal Obstruction Symptom Evaluation surveys completed at each annual visit. Main Outcome Measures: Composite NOSE and individual symptom scores. Results: Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms ( P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes ( P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery ( P = .006). There was no significant difference ( P > .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding. Conclusions: There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population.

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Aleitamento materno em lactentes com fissura labiopalatina

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i5a230983p1390-1396-2018 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1390

Author(s):

Armando Dos Santos Trettene ◽

Thais De Oliveira Maximiano ◽

Carolina Cantatore Beraldo ◽

Juliana Campanati Mendonça ◽

Aline Godoi Luiz ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Bottle Feeding ◽

Chi Square ◽

Cross Sectional ◽

Prenatal Health ◽

Factors Associated ◽

Nursing Visit ◽

Chi Square Test

RESUMOObjetivo: identificar fatores associados à adesão ao aleitamento materno em lactentes com fissura de lábio e/ou palato. Método: estudo quantitativo, transversal, com 121 cuidadores de crianças com fissura de lábio e/ou palato. A coleta de dados foi realizada durante a consulta de Enfermagem pré-operatória de queiloplastia e/ou palatoplastia. Os pais/responsáveis responderam a um questionário referente ao recebimento de informações sobre o aleitamento materno recebidas no pré e pós-natal. Para a análise estatística, utilizou-se o teste Qui-quadrado, com significância de 5%. Resultados: o aleitamento materno exclusivo foi observado em 31% (n=38) dos lactentes. Desses, 63% (n=24) foram amamentados por um mês. Entre os fatores para a não adesão ao aleitamento materno prevaleceu a sucção ineficaz (n=45, 37%). Possuir fissura de lábio e palato influenciou negativamente a prática do aleitamento materno (p<0,001), enquanto receber orientações no pré-natal favoreceu a sua adesão (p=0,042). Conclusão: poucos lactentes foram amamentados exclusivamente e por tempo aquém do recomendado. A complexidade da fissura, evidenciada pelo déficit de sucção, influenciou negativamente a adesão ao aleitamento materno, enquanto o recebimento de informações por profissionais de saúde no pré-natal influenciou positivamente. Descritores: Aleitamento Materno; Cuidados de Enfermagem; Fissura Labial; Fissura Palatina; Alimentação Artificial; Enfermagem.ABSTRACTObjective: to identify factors associated with adherence to breastfeeding in infants with cleft lip and / or palate. Method: quantitative, cross-sectional study with 121 caregivers of children with cleft lip and / or palate. Data collection was carried out during the preoperative nursing visit of queiloplasty and / or palatoplasty. The parents / guardians answered a questionnaire regarding the receipt of information about breastfeeding received in the pre- and postnatal care. For the statistical analysis, the chi-square test was used, with significance of 5%. Results: exclusive breastfeeding was observed in 31% (n = 38) of infants. Of these, 63% (n = 24) were breastfed for one month. Among the factors for non-adherence to breastfeeding, ineffective sucking (n = 45, 37%) prevailed. Posterior cleft lip and palate negatively influenced the practice of breastfeeding (p <0.001), while receiving prenatal guidelines favored its adherence (p = 0.042). Conclusion: few infants were breastfed exclusively and for shorter time than recommended. The complexity of the cleft, evidenced by sucking deficit, negatively influenced adherence to breastfeeding, while the receipt of information by prenatal health professionals influenced positively. Descritores: Breast Feeding; Nursing Care; Cleft Lip; Cleft Palate; Bottle Feeding; Nursing.RESUMENObjetivo: identificar factores asociados a la adhesión a la lactancia materna en lactantes con fisura de labio y / o paladar. Método: estudio cuantitativo, transversal, con 121 cuidadores de niños con fisura de labio y / o paladar. La recolección de datos fue realizada durante la consulta de Enfermería preoperatoria de queiloplastia y / o palatoplastia. Los padres / responsables respondieron un cuestionario referente a la recepción de informaciones referentes a la lactancia materna, recibidas en el pre y post-natal. Para el análisis estadístico, se utilizó el testeo Qui-cuadrado, con significancia de 5%. Resultados: la lactancia materna exclusiva se observó en un 31% (n = 38) de los lactantes. De ellos, 63% (n = 24) fueron amamantados por un mes. Entre los factores para la no adhesión a la lactancia materna prevaleció la succión ineficaz (n = 45, 37%). La posesión de fisura de labio y paladar influenció negativamente la práctica de la lactancia materna (p <0,001), mientras que recibir orientaciones en el prenatal favoreció la su adhesión (p = 0,042). Conclusión: pocos lactantes fueron amamantados exclusivamente y por tiempo por debajo de lo recomendado. La complejidad de la fisura evidenciada por el déficit de succión, influenció negativamente la adhesión a la lactancia materna, mientras que la recepción de informaciones por profesionales de salud en el prenatal influenció positivamente. Descritores: Lactancia Materna; Atención de Enfermaría; Labio Leporino; Fisura del Paladar; Alimentación Artificial; Enfermaría.

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Demographic Factors Associated with Congenital Malformations Among Young Infants in Fallujah Maternity and Children Hospital, Fallujah City, Iraq

10.31487/j.gg.2020.01.03 ◽

2020 ◽

pp. 1-5

Author(s):

Samira T.Abdulghani ◽

Samira T.Abdulghani

Keyword(s):

Developing Countries ◽

Congenital Anomalies ◽

Prevalence Rate ◽

Gestational Hypertension ◽

Heart Defects ◽

Demographic Factors ◽

Cross Sectional ◽

Factors Associated ◽

Young Infants ◽

History Of

Background: Congenital anomalies are a major cause of infant morbidity and mortality in developing countries including our country. Registries and data on these anomalies are still primitive and poorly collated. In this study we aimed to assess the important demographic factors associated with the development of congenital anomalies. Methods: This was a cross-sectional hospital-based study involving 880 infants in the 1st year of life registered in the birth defect unit in Fallujah Maternity and Children Hospital in the period between 1st of January 2017 to the 31st of December 2019. The prevalence rate, the pattern of anomalies and the factors associated with their occurrence were determined. Results: The prevalence rate of the group enrolled in this study was 31/1000 total births, congenital heart defects was the commonest followed by central nervous system anomalies, 58% of the infants were males, 65% had ≥ 2.5 kg birth weight & 95% were singletons. Family history of congenital anomalies was found in 31.25% of cases. The largest group of mothers (55.7%) were 21-30 years old & 92.5% of fathers were less than 45 years old. Parental consanguinity reported in 64.3% of the total cases. Only 4.5% of mothers reported history of fever during pregnancy, and none of them had history of exposure to x-ray or teratogenic drug use. Gestational hypertension was reported in 10% of the total (880) mothers, hypertension and diabetes mellitus in 0.3%, while hepatitis C, hepatitis B, toxoplasmosis and epilepsy, each was reported in only one mother (0.1% of the total). Regarding the outcome of pregnancy, 66.6% were live births, 24.2% were abortions and 9.2% were stillbirths. History of previous abortions was reported in 22% of cases. Urban residents accounted for 63% of the families of congenitally abnormal infants while 37% were rural. Conclusion: Congenital anomalies are still a major cause for concern and tension in Fallujah society, there is serious need to establish a surveillance and good statistical system for congenital anomalies and efforts should be made to raise awareness of their occurrence and the associated risk factors in Iraq and other developing countries.

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The Relationship Between Maxillary Growth and Speech in Children With a Unilateral Cleft Lip and Palate at 5 Years of Age

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211010620 ◽

2021 ◽

pp. 105566562110106

Author(s):

Matthew Fell ◽

Jibby Medina ◽

Kate Fitzsimons ◽

Miriam Seifert ◽

Anne Roberts ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Poor Growth ◽

History Of ◽

Dental Models ◽

Maxillary Growth ◽

Growth Scores ◽

Outcomes For Children ◽

The Relationship ◽

Normal Speech

Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age. Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Northern Ireland were included in this study. Outcome Measures: Maxillary growth was analyzed using dental models scored by the 5-Year-Olds’ index, and perceptual speech analyses were scored by the Cleft Audit Protocol for Speech – Augmented rating. Results: Forty-one percent of the children achieved good maxillary growth (scores 1 and 2 on 5-Year-Old’ index). Fifty percent of the children achieved normal speech (achieving UK speech standard 1). Maxillary growth was not found to have an impact on speech outcome when described by the 3 UK National Cleft Lip and Palate Speech Audit Outcome Standards. Analysis according to individual speech parameters showed dentalizations to be less prevalent in children with good maxillary growth compared to fair and poor growth ( P = .001). The remaining speech parameters within resonance, nasal airflow, and articulation categories were not significantly associated with maxillary growth. Conclusion: The findings from this study suggest that children with a history of complete UCLP, who have poor maxillary growth, are not at a higher risk of having major speech errors compared to children with good or fair maxillary growth at 5 years of age.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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