Lek, L. van der (Lisanne) (2019) Klinische en epidemiologische trend analyse naar het seizoensgebonden ontstaan van schisis in Nederland. thesis, Medicine.
Full text available on request.Abstract
Background – In the multifactorial etiology of facial clefts environmental factors play an important role. Fusion and differentiation of the lip, alveolus and palate take place during the first trimester of pregnancy. During this period harmful seasonal influences like viral infections and vitamin deficiencies could induce a facial cleft in the embryo. Because we observed a marked variation in the number of newborns with facial clefts, this study investigates the hypothesis that conception during winter increases the risk of facial cleft development. Aim – The aim of this study was to look for possible monthly and seasonal differences in the conception rates of children with facial clefts and thus to find a period of conception that can increase the risk of facial cleft development. Methods – This is a retrospective cross-sectional study on children with facial clefts born in the Netherlands and whose conception took place from 2006 to 2015. Children with nonCaucasian or consanguineous parents, children with a syndrome, sequence or association, and adoptive or foster children were excluded. Total monthly and seasonal conception rates available from the official database of the Dutch Statistical Office were used as a control group. Chi-square tests were performed to analyse monthly and seasonal differences in conception rates. Cleft boys and cleft girls, cleft children with and without a positive family history and the subphenotype categories based on underlying developmental mechanisms and their timing in embryogenesis were analysed separately. Results – In total 1653 children, including 1041 boys and 612 girls, were analysed. 528 children had a cleft of the primary palate, 478 of the secondary palate and 647 of both structures. Of all children 921 had a fusion defect, 454 a differentiation defect and 278 a combination of both. 103 clefts originated in the early embryonic period, 969 in the late embryonic period and 581 in both periods. Cleft boys with both fusion and differentiation defects showed a significant seasonal variation with an increase of conceptions during spring. The other cleft groups did not significantly differ from the control group in seasonal fluctuations. Cleft boys and cleft girls showed significant differences in monthly numbers of conceptions and their distribution across the different cleft groups. Conclusion – Boys with both fusion and differentiation defects showed a significant seasonal variation with an increase of conceptions during spring. No other seasonal trends could be demonstrated. Cleft boys and cleft girls showed significant differences regarding seasonal variation and distribution across all subphenotypes.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Mouës-Vink, dr. C.M. and Instelling: Medisch Centrum Leeuwarden and Afdeling: Plastische-, Reconstructieve- en Handchirurgie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1570 |
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