The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates.There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group.Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention.ClinicalTrials.gov: NCT00097149Cleft lip and/or palate (CL/P) are common and burdensome birth defects, occurring in about 1 in 700 births, with variation by ethnicity and socioeconomic status [1]. CL/P occur in isolation or in association with other birth defects. The isolated forms are a result of a complex etiology of genetic and environmental factors [2-8] The associated forms occur due to various etiologies involving more than 500 Mendelian disorders, chromosome anomalies, teratogens and uncategorized syndromes [9]. CL/P may result in significant early life problems including feeding problems, surgery-related events, airway management and infections [10]. These complications increase early life mortality risk, particularly in associated forms [10-14]. CL/P are among the most common birth defects, and neonatal mortality from birth defects is a significant impediment to re