{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:44:08Z","timestamp":1761007448231,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007504","name":"boston medical center","doi-asserted-by":"publisher","award":["Purchased the 2016 Kids\u2019 Inpatient Database"],"award-info":[{"award-number":["Purchased the 2016 Kids\u2019 Inpatient Database"]}],"id":[{"id":"10.13039\/100007504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cleft lip and\/or cleft palate (CLP) is the most common major congenital malformation of the head and neck. Previous studies suggested an association between fetal opioid exposure and CLP. This study seeks to evaluate the associations between CLP and neonatal abstinence syndrome (NAS) in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Population\u2010based inpatient registry analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Kids\u2019 Inpatient Database (2016) was used to identify weighted in\u2010hospital births with diagnoses of CLP or NAS. Demographic information was obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 3.8\u00a0million weighted in\u2010hospital births, prevalence rates of CLP in the NAS and non\u2010NAS populations were 3.13 and 1.35 per 1000, respectively. The odds ratios for patients with NAS developing CLP, isolated cleft palate, isolated cleft lip, and cleft lip and palate when compared with the reference population were 2.33 (95% CI, 1.87\u20102.91; <jats:italic>P<\/jats:italic> &lt;. 001), 4.97 (95% CI, 3.84\u20106.43; <jats:italic>P<\/jats:italic> &lt;. 001), 1.01 (<jats:italic>P<\/jats:italic> =. 98), and 0.80 (<jats:italic>P<\/jats:italic> =. 46). Independent predictors of CLP within the NAS population included median household income for patients\u2019 zip code, race, hospital region, payment method, and maternal use of tobacco or other drugs of addiction. The binary logistic regression model accounting for possible confounding variables produced an odds ratio of 1.74 (95% CI, 1.36\u20102.23; <jats:italic>P<\/jats:italic> &lt;. 001) for the association between NAS and CLP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study found an association between NAS and CLP, specifically isolated cleft palate, suggesting that prenatal exposure to opioids may be an environmental risk factor in the development of CLP.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820944899","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T04:10:37Z","timestamp":1595304637000},"page":"199-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cleft Lip and Palate in Newborns Diagnosed With Neonatal Abstinence Syndrome"],"prefix":"10.1002","volume":"164","author":[{"suffix":"III","given":"David O\u2019Neil","family":"Danis","sequence":"first","affiliation":[{"name":"School of Medicine Boston University Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Bachrach","sequence":"additional","affiliation":[{"name":"School of Medicine Boston University Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn","family":"Piraquive","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Boston Medical Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander P.","family":"Marston","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Tufts Medical Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica R.","family":"Levi","sequence":"additional","affiliation":[{"name":"School of Medicine Boston University Boston Massachusetts USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Boston Medical Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2014.07.002"},{"volume-title":"Global Registry and Database on Craniofacial Anomalies: Report of a WHO Registry Meeting on Craniofacial Anomalies","year":"2001","author":"Mossey PA","key":"e_1_2_8_3_1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23329"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60695-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.31447"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1597\/02-074.1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1995.tb00857.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000092"},{"issue":"3","key":"e_1_2_8_10_1","first-page":"336","article-title":"Exposure to prescribed drugs in pregnancy and association with congenital malformations","volume":"58","author":"Bracken MB","year":"1981","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016357509004631"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/4.1.37"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4131"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3524"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1600879"},{"key":"e_1_2_8_16_1","unstructured":"Healthcare Cost and Utilization Project. 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