{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:18:46Z","timestamp":1787545126341,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cleft lip with or without cleft palate (CL\/P) is a prevalent congenital anomaly influenced by multifactorial genetic and environmental factors. This study investigated the prevalence, temporal trends, diversity, unclassified cases, and associated risk factors for isolated CL\/P in a tertiary Iranian hospital setting over two decades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of 767 isolated CL\/P cases from 620,000 live births at 15 Khordad Hospital (Tehran, Iran) from 2003 to 2023 was conducted. Data were extracted from anonymized medical records, focusing on demographic, perinatal, and clinical variables. Prevalence was calculated per 10,000 live births, with Cochran\u2010Armitage trend tests for temporal patterns. Univariable and multivariable logistic regression assessed associations, adjusted for confounders (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prevalence was 1.24 per 1000 live births (95% CI: 1.15\u20131.33), with male predominance (59.7%; ratio 1.59:1). A significant non\u2010linear temporal pattern was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045), with fluctuations peaking mid\u20102010s. Diversity included 48.4% combined CL\/P, 71.6% unilateral (42.1% left), and 58.7% complete forms; 4.3% were unclassified \u201cnasal\u2010dominant variants.\u201d Multivariable models identified maternal smoking (11\u201320 cigarettes\/day: aOR 1.52, 95% CI 1.30\u20131.78), obesity (extreme: aOR 1.37, 95% CI 1.23\u20131.53), pre\u2010pregnancy diabetes (aOR 2.00, 95% CI 1.68\u20132.38), hypertension (aOR 1.20, 95% CI 1.05\u20131.37), previous preterm birth (aOR 1.44, 95% CI 1.30\u20131.60), and assisted reproductive technology (aOR 1.42, 95% CI 1.18\u20131.71) as risks; higher education (aOR 0.82, 95% CI 0.74\u20130.91) and maternal age 30\u201334\u2009years (aOR 0.90, 95% CI 0.81\u20131.00) were protective (Nagelkerke\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.18).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Isolated CL\/P in Iran exhibits stable yet fluctuating trends, driven by modifiable maternal risks amenable to preconception interventions. Enhanced public health strategies targeting smoking and obesity could reduce incidence by 15%\u201325%, aligning with global goals for congenital anomaly prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70079","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:14:31Z","timestamp":1781698471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, Temporal Trends, Diversity, and Associated Risk Factors of Isolated Cleft Lip With or Without Cleft Palate: A 20\u2010Year Retrospective Hospital\u2010Based Study in Iran (2003\u20132023)"],"prefix":"10.1002","volume":"118","author":[{"given":"Abdoljalil","family":"Kalantar\u2010Hormozi","sequence":"first","affiliation":[{"name":"Department of Plastic and Craniofacial Surgery, School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Motallebi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Faculty of Medicine, 5th Azar Hospital Medical and Educational Center Golestan University of Medical Sciences  Gorgan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Abrishami","sequence":"additional","affiliation":[{"name":"Department of Oral &amp; Maxillofacial Surgery, Faculty of Dentistry Isf. C, Islamic Azad University  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1597\/15-219"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes14081603"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.028"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008095"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-03797-z"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211057368"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2009.01577.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005385"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009591"},{"issue":"3","key":"e_1_2_10_12_1","first-page":"213","article-title":"Tobacco Smoking and Oral Clefts: A Meta\u2010Analysis","volume":"82","author":"Little J.","year":"2004","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14786"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa272"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000011151"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41415-023-5993-4"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60695-4"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000337464"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311x00115813"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.15761\/OHNS.1000246"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/children11030322"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.S1.1152"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2009.01587.x"},{"key":"e_1_2_10_24_1","volume-title":"Birth Defects Surveillance: A Manual for Programme Managers","author":"World Health Organization, Prevention Control CfD","year":"2020"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bdr2.70079","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.70079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T03:29:06Z","timestamp":1787542146000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.70079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/bdr2.70079"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.70079","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70079"}}