title: Temporal trend in the reported birth prevalence of cleft lip and/or cleft palate in Brazil, 2000 to 2013.
abstract: BACKGROUND
  The birth prevalence of cleft lip with or without cleft palate (CL/P) in Brazil increased between the years from 1975 to 1994 but has not been evaluated for temporal trend since then.
  
  
  METHODS
  We used data from the Brazilian National Health Information System for the years 2000 through 2013. We calculated the reported CL/P birth prevalence each year per 10,000 live births and estimated the average increase in reported prevalence per year (and 95% confidence interval [CI]) by fitting a negative binomial regression model. We also estimated the temporal trend in each of the five Brazilian regions for this time period.
  
  
  RESULTS
  The overall reported birth prevalence was 4.85 (95% CI, 4.78-4.91) per 10,000 live births. The reported birth prevalence of CL/P increased over this time period, from 3.94 (95% CI, 3.73-4.17) per 10,000 in 2000 to 5.46 (95% CI, 5.20-5.74) per 10,000 in 2013. The temporal trend differed for different Brazilian geographic regions, being confined primarily to the Northeast (4.7% per year; 95% CI, 4.0%-5.5%), North (3.3% per year; 95% CI, 1.8%-4.7%), and Central (2.9% per year; 95% CI, 0.9%-4.9%) regions.
  
  
  CONCLUSIONS
  In recent years, there appears to be an upward trend in the reported prevalence of CL/P in Brazil, confined to the less developed regions of the country. The increase likely reflects improved surveillance; whether it also reflects etiologic differences is unknown. Birth Defects Research (Part A) 106:789-792, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Community and Preventive Dentistry, UFMG. maurohenriqueabreu@gmail.com.
authors.forename: Mauro Henrique Nogueira Guimarães
authors.initials: MH
authors.lastname: Abreu
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts.
authors.forename: Kyu Ha
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, University of Washington.
authors.forename: Daniela Varela
authors.initials: DV
authors.lastname: Luquetti
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts. jstarr@forsyth.org.
authors.forename: Jacqueline Rose
authors.initials: JR
authors.lastname: Starr
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002971:Cleft Lip / Q000453:epidemiology*; D002972:Cleft Palate / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence
keywords: cleft lip; cleft palate; epidemiology; health information systems; time series analysis