CLEFT LIP AND PALATE AND THE CORRELATION WITH SURGICAL CORRECTION BETWEEN 2012 AND 2022: EPIDEMIOLOGICAL ANALYSIS IN BRAZIL

Abstract

INTRODUCTION: Cleft lip and palate (CLP), also known as cleft lip and palate or cleft lip and palate, is a congenital malformation that primarily affects the face and oral region. This condition results from the non-union or incomplete junction of craniofacial structures during the embryonic phase of fetal development. Cleft lip and palate are classified as cleft lip, palate, and cleft palate. The causes of this condition are multifactorial, involving genetic and environmental factors, such as maternal smoking, use of antiepileptic medications, and excessive alcohol consumption (1). In Brazil, the prevalence of cleft lip and palate ranges from 0.47 to 1.54 per thousand live births (6). Early identification and diagnosis of this malformation are crucial to minimize its physical, social, and psychological impacts, requiring surgical treatment and specialized monitoring. OBJECTIVE: The objective of this study is to analyze data on births with cleft lip and palate in Brazil between 2012 and 2022, correlating them with surgical procedures performed in the country. The study focuses on the costs associated with treatment, length of hospital stay, and the geographic distribution of this condition. METHODOLOGY: This is an ecological, retrospective, and descriptive study. Data from the Live Birth Information System (SINASC) and hospital production (SIH/SUS) were used. The analysis covered the geographic regions of Brazil, with data on sex, color/race, types of malformations, and procedures performed, considering the period from 2012 to 2022. RESULTS: A total of 16,657 births with cleft lip and palate were recorded between 2012 and 2022, with a higher prevalence in the Southeast and Northeast regions. Cleft lip and palate was more common in males (58.47%) and mixed-race individuals (50.41%). During the same period, 12,481 primary palatoplasty procedures were performed, with a higher concentration in the Southeast (51.59%). The total cost of CLP treatment was R$17,997,854.57, with 20,313 days of hospitalization. DISCUSSION: Adjusted rates per 100,000 population showed a higher prevalence in the Southeast and Northeast regions, reflecting both the greater number of births and unequal access to specialized services. Studies such as those by Mossey et al. (2009) and WHO (2018) confirm that the prevalence is higher in regions with better health infrastructure. The decrease in procedures between 2020 and 2022, mainly due to the pandemic, was also observed in other countries, such as the USA. Early surgical correction, in addition to improving children's quality of life, can reduce long-term costs (Fell et al., 2014). The literature also indicates that access to treatment is significantly greater in regions with more resources. CONCLUSION: This study demonstrated the high prevalence of cleft lip and palate in Brazil and the large regional disparities in access to surgical correction. The results indicate that, although correction is more common in the Southeast and Northeast regions, significant challenges exist in regions with less health infrastructure. Implementing more effective screening programs and improving access to treatment are essential to reduce regional disparities and improve outcomes for affected children.