{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:14:26Z","timestamp":1784290466767,"version":"3.55.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2008,9,1]],"date-time":"2008-09-01T00:00:00Z","timestamp":1220227200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify preferential associations between oral clefts (CL \u200a=\u200a cleft lip only, CLP \u200a=\u200a cleft lip with cleft palate, CP \u200a=\u200a cleft palate) and nonoral cleft anomalies, to interpret them on clinical grounds, and, based on the patterns of associated defects, to establish whether CL and CLP are different conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design And Settings:<\/jats:title>\n                    <jats:p>Included were 1416 cleft cases (CL \u200a=\u200a 131, CLP \u200a=\u200a 565, CP \u200a=\u200a 720), among 8304 live- and stillborn infants with multiple congenital anomalies, from 6,559,028 births reported to the International Clearinghouse for Birth Defects Surveillance and Research by 15 registries between 1994 and 2004. Rates of associated anomalies were established, and multinomial logistic regressions applied to identify significant associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Positive associations with clefts were observed for only a few defects, among which anencephaly, encephaloceles, club feet, and ear anomalies were the most outstanding. Anomalies negatively associated with clefts included congenital heart defects, VATER complex (vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia), and spina bifida.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The strong association between all types of clefts and anencephaly seems to be attributable to cases with disruptions; the association between CP and club feet seems to be attributable to conditions with fetal akinesia. Some negative associations may depend on methodologic factors, while others, such as clefts with VATER components or clefts with spina bifida, may depend on biological factors. The different patterns of defects associated with CL and CLP, indicating different underlying mechanisms, suggest that CL and CLP reflect more than just variable degrees of severity, and that distinct pathways might be involved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1597\/06-250.1","type":"journal-article","created":{"date-parts":[[2008,9,12]],"date-time":"2008-09-12T19:02:10Z","timestamp":1221246130000},"page":"525-532","source":"Crossref","is-referenced-by-count":47,"title":["Preferential Associations between Oral Clefts and Other Major Congenital Anomalies"],"prefix":"10.1177","volume":"45","author":[{"given":"Monica","family":"Rittler","sequence":"first","affiliation":[{"name":"Hospital Materno Infantil Ram\u00f3n Sard\u00e1, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge S.","family":"L\u00f3pez-Camelo","sequence":"additional","affiliation":[{"name":"Instituto Multidisciplinario de Biolog\u00eda Celular (IMBICE), and at Centro de Educaci\u00f3n M\u00e9dica e Investigaci\u00f3n Cl\u00ednica (CEMIC), Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo E.","family":"Castilla","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil, and at CEMIC, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Bermejo","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Cocchi","sequence":"additional","affiliation":[{"name":"Istituto Clinico Di Pediatria Preventiva e Neonatologia, Universit\u00e0 di Bologna, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Correa","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Csaky-Szunyogh","sequence":"additional","affiliation":[{"name":"Department of Human Genetics and Teratology, National Center for Epidemiology, Budapest, Hungary."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Danderfer","sequence":"additional","affiliation":[{"name":"BC Vital Statistics Agency, Victoria, British Columbia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"De Vigan","sequence":"additional","affiliation":[{"name":"INSERM U 149, Recherches Epid\u00e9miologiques en Sant\u00e9 P\u00e9rinatale et Sant\u00e9 de Femmes. Villejuif, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermien","family":"De Walle","sequence":"additional","affiliation":[{"name":"Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"da Gra\u00e7a Dutra","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiki","family":"Hirahara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luisa","family":"Mart\u00ednez-Fr\u00edas","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III, Madrid, Spain and Professor of the Department of Pharmacology, Faculty of Medicine, Universidad Complutense, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Merlob","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo","family":"Mutchinick","sequence":"additional","affiliation":[{"name":"Department of Genetics, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annukka","family":"Ritvanen","sequence":"additional","affiliation":[{"name":"National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Robert-Gnansia","sequence":"additional","affiliation":[{"name":"Registre de Malformations en Rhone-Alpes, Lyon, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"Scarano","sequence":"additional","affiliation":[{"name":"Osservatorio Epidemiologico Regionale, Assessorato alla Sanit\u00e0. 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