The effects of oral clefts on hospital use throughout the lifespan

We estimate two-part regression models for hospital admission and length of stay for several age groups up to 68 years of age. The study employs unique secondary population-based data from several administrative inpatient, civil registration, demographic and labor market databases for 7,670 individuals born with oral clefts between 1936 and 2002 in Denmark, and 220,113 individuals without oral clefts from a 5% random sample of the total birth population from 1936 to 2002.Oral clefts significantly increase hospital use for most ages below 60 years by up to 233% for children ages 0-10 years and 16% for middle age adults. The more severe cleft forms (cleft lip with palate) have significantly larger effects on hospitalizations than less severe forms.The results suggest that individuals with oral clefts have higher hospitalization risks than the general population throughout most of the lifespan.Birth defects are common health problems with life-long implications. For example, about 3% of all children in the United States (US) are born with birth defects [1]. Oral clefts or cleft lip and/or cleft palate are one of the most prevalent birth defects and include clefts of the lip with or without the palate or clefts of the palate only. More than 6,500 affected babies were born with oral clefts in 2001 in the US [1]. Oral cleft incidence ranges between 1 per 500 to 1 per 2500 births and varies by ancestral origin and socioeconomic status [2]. The majority of cases occur without other major birth defects [3,4]. A complex etiology of genetic and environmental factors likely contributes to oral clefts [5-11].Oral clefts are associated with difficulties in feeding, growth, cognitive development, speech and behavior and require several surgical, medical, nutritional, dental, and other healthcare interventions [12,13]. Oral clefts may significantly increase the risk of neonatal and infant mortality, especially when present with other birth defects [5,14-18]. Furthermore, oral cleft