Prevalence of non-syndromic orofacial clefts among jews and arabs, By type, Site, Gender and geography: A multi-center study in israel

Background: Orofacial clefts are the most common craniofacial congenital malformations, with significant anatomic, ethnic, racial and gender differences. Objectives: To investigate the prevalence, distribution and characteristic features of various types of non-syndromic clefts among Israeli Jews and Arabs. Methods: We conducted a retrospective multi-center survey in 13 major hospitals in Israel for the period 1993–2005. To obtain the true prevalence and detailed clinical characteristics, data on liveborn infants with non-syndromic clefts were obtained from the Ministry of Health’s National Birth Defect Registry and completed by chart reviews in the 13 surveyed hospitals. Results: Of 976, 578 liveborn infants, 684 presented unilateral or bilateral clefts, with a prevalence of 7.00/10, 000 live births; 479 were Jews and 205 were Arabs. The prevalence was higher among Arabs compared to Jews (11.12 and 6.22 per 10, 000 live births in Arabs and Jews, respectively, P < 0.00001). Males had higher cleft rates than females (7.69/10, 000 and 6.17/10, 000 live births, respectively, P = 0.05). Males had more cleft lips (P < 0.05) and cleft lips with cleft palate (P < 0.001). There was left-side predominance. Newborns of younger mothers (age < 20 years) and of older mothers (age ≥ 45 years) had higher cleft rates than those with mothers in the 20–44 year bracket (P < 0.009). Children born at or above the 5th birth order had a higher cleft rate (P < 0.001). Conclusions: The prevalence of non-syndromic clefts was 7.00/10, 000 live births. The markedly higher rate in Arabs is related to the high rate of consanguinity. Both very young and old maternal age represents a higher risk of clefts in their offspring.