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Regional differences in birth prevalence of cleft lip and/or palate in Sweden – a register study of all children born in Sweden between 2000 and 2020

Cornefjord, Måns LU orcid ; Källén, Karin LU ; Klintö, Kristina LU orcid ; Stiernman, Mia LU ; Wiedel, Anna Paulina LU and Becker, Magnus LU orcid (2025) In Journal of Plastic Surgery and Hand Surgery 60. p.196-203
Abstract

The birth prevalence of cleft lip and/or palate (CL/P) varies globally, and regional differences have previously been observed within Sweden. Updated data on CL/P birth prevalence is needed and has been requested nationally and internationally. This study investigated regional differences and temporal trends in the birth prevalences of CL/P and specific cleft subtypes across Sweden’s six health care regions (HC regions) from 2000 to 2020. Using data from the Swedish Medical Birth Register and the National Register of Congenital Anomalies (coverage 97–99%), the study included 2,230,771 children. Variables included were year and region of birth, and cleft diagnoses: cleft lip and/or palate (CL/P), cleft palate without cleft lip (CP),... (More)

The birth prevalence of cleft lip and/or palate (CL/P) varies globally, and regional differences have previously been observed within Sweden. Updated data on CL/P birth prevalence is needed and has been requested nationally and internationally. This study investigated regional differences and temporal trends in the birth prevalences of CL/P and specific cleft subtypes across Sweden’s six health care regions (HC regions) from 2000 to 2020. Using data from the Swedish Medical Birth Register and the National Register of Congenital Anomalies (coverage 97–99%), the study included 2,230,771 children. Variables included were year and region of birth, and cleft diagnoses: cleft lip and/or palate (CL/P), cleft palate without cleft lip (CP), cleft lip with/without cleft palate (CL ± P), bilateral cleft lip with/without cleft palate (BCL ± P), and unilateral/bilateral cleft lip and palate (UCLP, BCLP). Poisson regression models were used to assess regional differences and trends. The Stockholm HC region had the lowest prevalence for all cleft types except CP. The Northern HC region had a higher CP prevalence, while clefts involving the lip (CL ± P, BCL ± P) were more common in the Southeastern and Southern HC regions. Declining trends were observed in at least two regions for all cleft types except CP. CL/P, CL ± P, and BCL ± P showed decreasing prevalence in three regions. The findings confirm some previously reported regional patterns, including a higher CP birth prevalence in northern Sweden. Potential explanations for the regional differences include genetic variation, differences in attitude towards pregnancy termination, socioeconomic factors, and exposure to other risk factors, but need further examination.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
birth prevalence, cleft lip, Cleft lip and palate, cleft palate, cleft types, geographical differences, incidence, regional differences, Sweden, trends
in
Journal of Plastic Surgery and Hand Surgery
volume
60
pages
8 pages
publisher
Medical Journals Sweden AB
external identifiers
  • pmid:41117523
  • scopus:105019629673
ISSN
2000-656X
DOI
10.2340/jphs.v60.44798
language
English
LU publication?
yes
id
57c7dc25-2324-43f1-a1a5-2c3d8f163e31
date added to LUP
2025-12-16 13:53:16
date last changed
2025-12-17 03:20:00
@article{57c7dc25-2324-43f1-a1a5-2c3d8f163e31,
  abstract     = {{<p>The birth prevalence of cleft lip and/or palate (CL/P) varies globally, and regional differences have previously been observed within Sweden. Updated data on CL/P birth prevalence is needed and has been requested nationally and internationally. This study investigated regional differences and temporal trends in the birth prevalences of CL/P and specific cleft subtypes across Sweden’s six health care regions (HC regions) from 2000 to 2020. Using data from the Swedish Medical Birth Register and the National Register of Congenital Anomalies (coverage 97–99%), the study included 2,230,771 children. Variables included were year and region of birth, and cleft diagnoses: cleft lip and/or palate (CL/P), cleft palate without cleft lip (CP), cleft lip with/without cleft palate (CL ± P), bilateral cleft lip with/without cleft palate (BCL ± P), and unilateral/bilateral cleft lip and palate (UCLP, BCLP). Poisson regression models were used to assess regional differences and trends. The Stockholm HC region had the lowest prevalence for all cleft types except CP. The Northern HC region had a higher CP prevalence, while clefts involving the lip (CL ± P, BCL ± P) were more common in the Southeastern and Southern HC regions. Declining trends were observed in at least two regions for all cleft types except CP. CL/P, CL ± P, and BCL ± P showed decreasing prevalence in three regions. The findings confirm some previously reported regional patterns, including a higher CP birth prevalence in northern Sweden. Potential explanations for the regional differences include genetic variation, differences in attitude towards pregnancy termination, socioeconomic factors, and exposure to other risk factors, but need further examination.</p>}},
  author       = {{Cornefjord, Måns and Källén, Karin and Klintö, Kristina and Stiernman, Mia and Wiedel, Anna Paulina and Becker, Magnus}},
  issn         = {{2000-656X}},
  keywords     = {{birth prevalence; cleft lip; Cleft lip and palate; cleft palate; cleft types; geographical differences; incidence; regional differences; Sweden; trends}},
  language     = {{eng}},
  pages        = {{196--203}},
  publisher    = {{Medical Journals Sweden AB}},
  series       = {{Journal of Plastic Surgery and Hand Surgery}},
  title        = {{Regional differences in birth prevalence of cleft lip and/or palate in Sweden – a register study of all children born in Sweden between 2000 and 2020}},
  url          = {{http://dx.doi.org/10.2340/jphs.v60.44798}},
  doi          = {{10.2340/jphs.v60.44798}},
  volume       = {{60}},
  year         = {{2025}},
}