title: [Cleft lip/palate and flour fortification with folic acid in Chile].
abstract: BACKGROUND
  The effect of food fortification with folic acid on the incidence of lip-palate fissures (FLP) is under discussion.
  
  
  OBJECTIVE
  To calculate the rate of hospital discharges due to cleft lip and palate (CLP) and explore whether they decreased after the start of folic acid fortification in Chile.
  
  
  METHODS
  The hospital discharge databases published by the Chilean Ministry of Health were analyzed. The trends of discharge rates due to CLP of children of less than one year of life (ICD-10 Q350-379 code) and live births (lb) were calculated from 1986 to 2012. Variables such as incidence of rubella, poverty rate, obesity in pregnant women, and percentage of women who smoked or drank alcohol in the last month were included. The relative risk (RR) of CLP pre-fortification (1986-1999) and post-fortification (2000-2010) was calculated. Mixed and Prais-Winsten models were used to adjust other variables.
  
  
  RESULTS
  The hospital discharge rate due to CLP decreased from 1.88 x 1,000 lb during 1986-1996 to 1.68 x 1,000 lb (RR = 1.09 (95% CI 1.05-1.14, p < 0.001). Prais-Winsten and Mixed models, determined that folic acid fortification is the variable explaining this decrease. During 2004-2011, hospital discharge rates for cleft lip decreased but there was an increase in the figures for cleft lip and palate.
  
  
  CONCLUSIONS
  The 9% decrease in hospital discharge rates for CLP is concomitant with wheat folic acid fortification.
authors.forename: Angélica
authors.initials: A
authors.lastname: Paulos
authors.forename: Paulina
authors.initials: P
authors.lastname: Pino
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cavada
authors.forename: Carolina
authors.initials: C
authors.lastname: Lagos
authors.forename: Valentina
authors.initials: V
authors.lastname: Broussain
authors.forename: Andrea
authors.initials: A
authors.lastname: Hasbún
mesh_terms: D002677:Chile / Q000453:epidemiology; D002971:Cleft Lip / Q000453:epidemiology* / Q000517:prevention & control; D002972:Cleft Palate / Q000453:epidemiology* / Q000517:prevention & control; D005433:Flour / Q000032:analysis; D005492:Folic Acid / Q000008:administration & dosage*; D005527:Food, Fortified; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015999:Multivariate Analysis; D009436:Neural Tube Defects / Q000517:prevention & control; D010351:Patient Discharge / Q000706:statistics & numerical data*
chemical_list: D005492:Folic Acid