Email updates

Keep up to date with the latest news and content from BMC Pediatrics and BioMed Central.

Open Access Research article

The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

George L Wehby1, Eduardo E Castilla2, Norman Goco3, Monica Rittler4, Viviana Cosentino5, Lorette Javois6, Mark Kindem57, Hrishikesh Chakraborty8, Graca Dutra9, Jorge S López-Camelo10, Iêda M Orioli11 and Jeffrey C Murray12*

Author Affiliations

1 College of Public Health, Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA

2 ECLAMC (Latin American Collaborative Study of Congenital Malformations) at Cemic, Buenos Aires, Argentina; ECLAMC at Instituto Oswaldo Cruz, Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics

3 Statistic Research Division, RTI International, Research Triangle Park, NC, USA

4 ECLAMC at Maternidad Ramón Sardá, Buenos Aires, Argentina

5 ECLAMC at Cemic, Buenos Aires, Argentina

6 Developmental Biology, Genetics and Teratology Branch, Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

7 Statistic Research Division, RTI International, Research Triangle Park, NC, USA

8 Department of Epidemiology and Biostatistics, Arnold School of Public Health The University of South Carolina, Columbia, SC, USA

9 ECLAMC at Instituto Oswaldo Cruz, Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics

10 ECLAMC at Imbice, La Plata, Argentina; ECLAMC (Latin American Collaborative Study of Congenital Malformations) at Cemic, Buenos Aires, Argentina

11 ECLAMC at Departamento de Genética, Universidade Federal do Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics

12 College of Medicine, Department of Pediatrics, University of Iowa, Iowa City, IA, USA

For all author emails, please log on.

BMC Pediatrics 2011, 11:121  doi:10.1186/1471-2431-11-121

Published: 28 December 2011

Abstract

Background

Cleft lip and/or palate (CL/P) increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P) in South America.

Methods

The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates.

Results

There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group.

Conclusions

Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention.

Trial Registration

ClinicalTrials.gov: NCT00097149