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Long term follow up study of survival associated with cleft lip and palate at birth

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.38106.559120.7C (Published 10 June 2004) Cite this as: BMJ 2004;328:1405
  1. Kaare Christensen, professor (kchristensen{at}health.sdu.dk)1,
  2. Knud Juel, senior researcher2,
  3. Anne Maria Herskind, paediatrician3,
  4. Jeffrey C Murray, professor4
  1. 1 Center for the Prevention of Congenital Malformations, Institute of Public Health, University of Southern Denmark, DK-5000 Odense, Denmark
  2. 2 National Institute of Public Health, DK-2100 Copenhagen, Denmark
  3. 3 Odense University Hospital, Department of Pediatrics, DK-5000 Odense, Denmark
  4. 4 University of Iowa, Department of Pediatrics, Iowa City, IA 52242, USA
  1. Correspondence to: K Christensen
  • Accepted 1 April 2004

Abstract

Objective To assess the overall and cause specific mortality of people from birth to 55 years with cleft lip and palate.

Design Long term follow up study.

Setting Danish register of deaths.

Participants People born with cleft lip and palate between 1943 and 1987, followed to 1998.

Main outcome measures Observed and expected numbers of deaths, summarised as overall and cause specific standardised mortality ratios.

Results 5331 people with cleft lip and palate were followed for 170 421 person years. The expected number of deaths was 259, but 402 occurred, corresponding to a standardised mortality ratio of 1.4 (95% confidence interval 1.3 to 1.6) for males and 1.8 (1.5 to 2.1) for females. The increased risk of mortality was nearly constant for the three intervals at follow up: first year of life, 1-17 years, and 18-55 years. The participants had an increased risk of all major causes of death.

Conclusions People with cleft lip and palate have increased mortality up to age 55. Children born with cleft lip and palate and possibly other congenital malformations may benefit from specific preventive health measures into and throughout adulthood.

Footnotes

  • Contributors KC was responsible for the content, conception, and design of the study, data collection and interpretation, drafting of the manuscript, obtaining funding, administrative support, and supervision. He will act as guarantor for the paper. AMH was responsible for part of the content, for conception and design, interpretation of data, critical revision of the manuscript, and technical support. KJ was responsible for part of the content, analysis and interpretation of the data, critical revision of the manuscript, and statistical expertise. JCM was responsible for the clinical perspective of the content, for analysis and interpretation of the data, critical revision of the manuscript, and supervision

  • Funding The Center for the Prevention of Congenital Malformations is supported by a grant from the Egmont Foundation. The Danish Cleft Lip and Palate Database has received support from the National Institute of Dental and Craniofacial Research (grant No R01 DE 11948) and the Egmont Foundation.

  • Competing interests None declared

  • Ethical approval The Danish Scientific-Ethical Committee (project Nos 90/251 and 95/32).

  • Accepted 1 April 2004
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