{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T16:16:54Z","timestamp":1780676214944,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005005","name":"Ben-Gurion University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005005","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pneumonia remains the primary cause of mortality among children under age 5. Cleft palate (CP) poses various challenges including velopharyngeal disfunction, potentially increasing rates of pneumonia. However, clinical evidence linking pneumonia to defect is lacking. This study aims to assess the prevalence of pneumonia and lower respiratory tract infections (LRTI) among CP patients through a population-based approach. This retrospective cohort study was conducted using medical records from Clalit Health Services in Israel, 2013\u20132022, encompassing population of 138,261 infants, including 166 with CP. We investigated the prevalence of pneumonia and other infectious diseases before and after palatoplasty, employing Poisson regression models adjusted for multiple demographic and clinical variables. A sibling comparison study was also conducted, analyzing 129 preoperative and 55 postoperative pairs. The preoperative analysis revealed an increased risk of pneumonia (relative risk [RR]: 5.8, 95% confidence interval (CI): 3.93\u20138.19), lower respiratory tract infections (LRTI) (\n                    <jats:italic>RR<\/jats:italic>\n                    : 1.55, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    : 1.12\u20132.06), and urinary tract infections (UTI) (\n                    <jats:italic>RR<\/jats:italic>\n                    : 5.27, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    : 3.23\u20138.03) in children with CP compared to controls. Following surgical repair, a statistically significant but reduced risk for pneumonia persisted up to 5\u00a0years (\n                    <jats:italic>RR<\/jats:italic>\n                    : 2.55, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    : 1.59\u20133.84). Sibling comparison analyses underscored an elevated pneumonia risk compared to CP siblings preoperatively (\n                    <jats:italic>RR<\/jats:italic>\n                    : 7.07, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    : 2.48\u201329.8). Postoperatively, the RR decreased and was no longer statistically significant (\n                    <jats:italic>RR<\/jats:italic>\n                    : 1.44, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    : 0.49\u20134.75).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Patients with CP are at higher risk for pneumonia, and the magnitude of risk may be reduced after palatoplasty.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              <jats:italic>\u2022 Cleft palate (CP) disrupts the separation of the nasal and oral cavities, leading to food regurgitation into the nasal cavity and theoretically may lead to respiratory tract infections.<\/jats:italic>\n                              <jats:italic>\u2022 The association between CP and respiratory tract infections has yet to be assessed thoroughly.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              <jats:italic>\u2022 This population-based study has shown that CP is an independent risk factor for pneumonia.<\/jats:italic>\n                              <jats:italic>\u2022 The risk for pneumonia among CP patients is lowered after surgical repair of the defect.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-024-05901-z","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:15:09Z","timestamp":1733098509000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of pneumonia among children with cleft palate before and after palatoplasty: a population-based study"],"prefix":"10.1007","volume":"184","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5192-4063","authenticated-orcid":false,"given":"Yotam","family":"Eyni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Kerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Danino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviv","family":"Goldbart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldad","family":"Silberstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"5901_CR1","doi-asserted-by":"crossref","unstructured":"Lozano R, Naghavi M, Lim SS, Ahn MPH SY, Alvarado MB, Andrews MPH KG et al (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 [Internet]. 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