# Trends in the Prevalence of Orofacial Clefts Among Hispanic Infants in the Rio Grande Valley of Texas (1997–2018)

## TL;DR

This study found that the rate of cleft lip with or without cleft palate increased in the Rio Grande Valley among Hispanic infants, while it decreased in other Texas regions.

## Contribution

The study identifies divergent trends in cleft lip prevalence between a predominantly Hispanic border region and non-border counties in Texas.

## Key findings

- CLP prevalence in the RGV increased from 2008 to 2018 compared to non-border counties.
- CLP prevalence decreased in non-border counties during the same period.
- No significant differences were found in cleft palate prevalence between regions.

## Abstract

Background

Orofacial clefts (OFCs), including the cleft lip with or without cleft palate (CLP) and cleft palate alone (CP), represent significant congenital anomalies with implications for feeding, speech, and psychosocial development. The Rio Grande Valley (RGV) of Texas, a predominantly Hispanic region that faces socioeconomic and healthcare challenges, may have a distinct OFC profile compared to non-border counties (NBCs) of Texas.

Methods

Prevalence data with 95% confidence intervals for OFCs from 1997 to 2018 were obtained from the Texas Department of State Health Services (DSHS). Definitions provided by the DSHS were adhered to, including only definite diagnoses. Given the large sample sizes and annual prevalence, a two-tailed z-score analysis was utilized to compare the RGV with NBCs, assuming normal approximation per the central limit theorem. Hispanic mothers were selected as the study population to minimize confounding by ethnicity, as the RGV has a predominantly Hispanic population.

Results

Overall, the prevalence of CLP among children born to Hispanic mothers in the RGV was higher than in NBCs (p = 0.26). The prevalence of CLP from 2008 to 2018 was significantly higher in the RGV than in NBCs (p = 0.006). From the first decade (1997-2007) to the second (2008-2018), the prevalence of CLP decreased significantly in NBCs (p = 0.016) and increased in the RGV (p = 0.06). No significant differences in the prevalence of CP were found across regions or time.

Conclusion

These findings suggest divergent temporal trends between CLP in the RGV versus NBCs. Therefore, there is a need for targeted public health interventions, given potential reporting limitations. Enhanced surveillance, improved diagnostic reporting (particularly in medically underserved and undocumented populations), and further research into environmental and socioeconomic determinants are warranted.