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

George L Wehby; Eduardo E Castilla; Norman Goco; Monica Rittler; Viviana Cosentino; Lorette Javois; Mark Kindem; Hrishikesh Chakraborty; Graca Dutra; Jorge S López-Camelo; Iêda M Orioli; Jeffrey C Murray

doi:10.1186/1471-2431-11-121

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

Journal article

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

George L Wehby, Eduardo E Castilla, Norman Goco, Monica Rittler, Viviana Cosentino, Lorette Javois, Mark Kindem, Hrishikesh Chakraborty, Graca Dutra, Jorge S López-Camelo, …

BMC pediatrics, Vol.11(1), pp.121-121

12/28/2011

DOI: 10.1186/1471-2431-11-121

PMCID: PMC3277464

PMID: 22204448

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Abstract

Background: Cleft lip and/or palate (CL/P) increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P) in South America. Methods: 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. Results: 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. Conclusions: 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.

Details

Title: Subtitle: The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts
Creators: George L Wehby - College of Public Health, Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA
Eduardo E Castilla - ECLAMC (Latin American Collaborative Study of Congenital Malformations) at Cemic, Buenos Aires, Argentina; ECLAMC at Instituto Oswaldo Cruz, Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics
Norman Goco - Statistic Research Division, RTI International, Research Triangle Park, NC, USA
Monica Rittler - ECLAMC at Maternidad Ramón Sardá, Buenos Aires, Argentina
Viviana Cosentino - ECLAMC at Cemic, Buenos Aires, Argentina
Lorette Javois - Developmental Biology, Genetics and Teratology Branch, Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
Mark Kindem - ECLAMC at Cemic, Buenos Aires, Argentina
Hrishikesh Chakraborty - Department of Epidemiology and Biostatistics, Arnold School of Public Health The University of South Carolina, Columbia, SC, USA
Graca Dutra - ECLAMC at Instituto Oswaldo Cruz, Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics
Jorge S López-Camelo - ECLAMC at Imbice, La Plata, Argentina; ECLAMC (Latin American Collaborative Study of Congenital Malformations) at Cemic, Buenos Aires, Argentina
Iêda M Orioli - ECLAMC at Departamento de Genética, Universidade Federal do Rio de Janeiro, Brazil; ECLAMC at INAGEMP: National Institute of Population Medical Genetics
Jeffrey C Murray - College of Medicine, Department of Pediatrics, University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: BMC pediatrics, Vol.11(1), pp.121-121
DOI: 10.1186/1471-2431-11-121
PMID: 22204448
PMCID: PMC3277464
NLM abbreviation: BMC Pediatr
ISSN: 1471-2431
eISSN: 1471-2431
Publisher: BioMed Central
Language: English
Date published: 12/28/2011
Academic Unit: Preventive and Community Dentistry; Anatomy and Cell Biology; Health Management and Policy; Stead Family Department of Pediatrics; Epidemiology; Economics; Pediatric Dentistry; Craniofacial Anomalies Research Center; Public Policy Center (Archive); Dental Research
Record Identifier: 9984025302202771

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