{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:45:14Z","timestamp":1790397914008,"version":"4.1.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To identify and review published data on the risks associated with cleft lip and\/or palate (CL\/P) in lower-middle-income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A systematic review of literature was performed on electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Literature on risks associated with CL\/P in LMICs, from 2010 to 2020, were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventeen studies met the inclusion criteria. All studies adopted an observational study design. Biological and environmental risks were identified. Maternal and paternal age (n = 7) and low socioeconomic status (n = 5) were the most prominently associated environmental risk factors. A strong association was identified between family history of cleft (n = 7) and CL\/P occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Environmental risk factors are now being investigated more than biological risk factors in LMICs, aiding health care workers in the early identification of possible cumulative effects of risks in CL\/P. Contextually relevant tools are recommended to promote early identification of at-risk infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656211018952","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T05:29:45Z","timestamp":1622438985000},"page":"568-576","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Cleft Lip and\/or Palate and Associated Risks in Lower-Middle-Income Countries: A Systematic Review"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1521-651X","authenticated-orcid":false,"given":"Kayla","family":"Kruppa","sequence":"first","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esedra","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlien","family":"Vorster","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie van","family":"der Linde","sequence":"additional","affiliation":[{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"key":"bibr1-10556656211018952","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23221"},{"key":"bibr2-10556656211018952","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003984"},{"issue":"1","key":"bibr3-10556656211018952","first-page":"472","volume":"9","author":"Ali MAM","year":"2019","journal-title":"Ann Med Health Sci Res"},{"key":"bibr4-10556656211018952","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006814"},{"key":"bibr5-10556656211018952","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30058-X"},{"key":"bibr6-10556656211018952","unstructured":"American Speech-Language-Hearing Association (ASHA). 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