Incidence of cleft lip and palate, and epidemiology of perinatal deaths related to cleft lip and palate in Hunan Province, China, 2016-2020

Background: This study aimed to analyze the incidence of cleft lip and/or palate (CL/P) and the epidemiology of perinatal death related to CL/P. Methods We used data from the Birth Defects Surveillance System of Hunan Province, China, from 2016 to 2020. The surveillance data of perinatal infants (for stillbirth, dead fetus, or live birth between 28 weeks of gestation and seven days after birth) were analyzed. We computed the incidences of CL/P and 95% confidence intervals (CI) by Poisson regression. Furthermore, we analyzed the epidemiology of perinatal deaths related to CL/P. Results A total of 847755 perinatal infants were registered between 2016–2020. 14459 birth defects were identified, including 685 (4.74%) CL/P. The incidence of CL/P was 0.81‰ (0.75–0.87‰) (per 1000 perinatal infants). And the incidences of the cleft lip only (CL) was 0.20‰ (0.17–0.23‰) (169 cases), of cleft palate only (CP) was 0.30‰ (0.26–0.33‰) (252 cases), and of cleft lip with palate (CLP) was 0.31‰ (0.27–0.35‰) (264 cases). The incidence of CL was higher in males than females (OR = 1.62, 95%CI: 1.18–2.22). The incidence of CP was higher in urban than rural (OR = 1.43, 95%CI: 1.12–1.83) and lower in males than females (OR = 0.59, 95%CI: 0.46–0.75). The incidence of CLP was higher in urban than in rural (OR = 1.36, 95%CI: 1.06–1.74). Compared to maternal aged 25–29 years, maternal aged < 20 years was a risk factor for CLP (OR = 3.62, 95%CI: 2.07–6.33) and CL/P (OR = 1.80, 95%CI: 1.13–2.86), and maternal aged ≥ 35 years was risk factor for CLP (OR = 1.43, 95%CI: 1.01–2.02). CL/P related perinatal deaths accounted for 24.96% (171/685) of all CL/P, of which 90.64% (155/171) were aborted. Rural residents, low income, low maternal age, and early prenatal diagnosis are risk factors for perinatal death. Conclusion This study contributes to a better understanding of the incidence and risk factors of CL/P in Hunan Province, China, which is important for public health decision-making and further research.