title: Incidence of cleft pathology in Greater New Orleans before and after Hurricane Katrina.
abstract: BACKGROUND
  Reports after the 2005 Hurricane Katrina have documented an increase in stress reactions and environmental teratogens (arsenic, mold, alcohol).
  
  
  OBJECTIVE
  To assess the incidence of cleft pathology before and after the hurricane, and the distribution of cleft cases by gender and race.
  
  
  METHODS
  Retrospective chart review of cleft lip with or without cleft palate (CL/P) and cleft palate (CP) cases registered with the Cleft and Craniofacial Team at Children's Hospital of New Orleans, the surgical center that treated cleft cases in Greater New Orleans between 2004 and 2007. Live birth data were obtained from the Louisiana State Center for Health Statistics.
  
  
  RESULTS
  The incidence of cleft cases, beginning 9 months after the hurricane (i.e., June 1, 2006) was significantly higher compared with the period before the hurricane (0.80 versus 1.42; p = .008). Within racial group comparisons showed a higher incidence among African Americans versus whites (0.42 versus 1.22; p = .01). The distribution of CL/P and CP cases by gender was significant (p = .05).
  
  
  CONCLUSIONS
  The increase in the incidence of cleft cases after the hurricane may be attributable to increased stress and teratogenic factors associated with the hurricane. The increase among African Americans may have been due to comparatively higher exposure to environmental risk factors. These findings warrant further investigation to replicate the results elsewhere in the Gulf to determine whether there is a causal relationship between environmental risk factors and increased cleft pathology.
authors.forename: Haig A
authors.initials: HA
authors.lastname: Goenjian
authors.forename: Ernest S
authors.initials: ES
authors.lastname: Chiu
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Alexander
authors.forename: Hugo
authors.initials: H
authors.lastname: St Hilaire
authors.forename: Michael
authors.initials: M
authors.lastname: Moses
mesh_terms: D002971:Cleft Lip / Q000453:epidemiology*; D002972:Cleft Palate / Q000453:epidemiology*; D055867:Cyclonic Storms; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D055820:New Orleans / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013723:Teratogens / Q000633:toxicity
chemical_list: D013723:Teratogens