{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:15:21Z","timestamp":1792548921248,"version":"4.5.0"},"reference-count":63,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Cleft lip with or without cleft palate (CL\/P) stands as the most common congenital facial anomaly, stemming from multifactorial causes. Objective: Our study aimed to ascertain the prevalence and characteristics of cleft palates, identify associated risk factors to inform prevention and prenatal detection for early intervention, and assess postoperative rehabilitation protocols for cleft palates. Design: This study employs a retrospective descriptive and clinical approach. Patients: The study includes 103 children with cleft palates treated at the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury. Methods: We conducted a thorough evaluation of records, considering variables such as sex, cleft type, maternal occupation, parental education, and family history of clefts. Data analysis was carried out using R software version GPL-3 and ordinal logistic regression analyses. Results: Notably, children born to mothers who experienced significant stress during pregnancy exhibited a 9.4-fold increase in the odds of having bilateral cleft palates. Conversely, no substantial evidence was found to support the influence of the child\u2019s sex, birth order, body mass, maternal exposure to workplace toxins, infections, or drug toxicity on the dependent variable. Conclusions: Our findings suggest that children with parents who have a history of clefts and those with less educated mothers are more likely to develop bilateral cleft palates. Additionally, children born to mothers experiencing stress during pregnancy face an increased risk of bilateral cleft palates. It is important to note that there is a paucity of literature on rehabilitation following various cleft palate surgical techniques in children.<\/jats:p>","DOI":"10.3390\/children11040399","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T12:52:12Z","timestamp":1711630332000},"page":"399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Characteristics of Factors Influencing the Occurrence of Cleft Lip and\/or Palate: A Case Analysis and Literature Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6026-0010","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Kulesa-Mrowiecka","sequence":"first","affiliation":[{"name":"Department of Rehabilitation in Internal Diseases, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9182-6953","authenticated-orcid":false,"given":"Anna","family":"Lipowicz","sequence":"additional","affiliation":[{"name":"Department of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2635-1074","authenticated-orcid":false,"given":"Bo\u017cena Anna","family":"Marsza\u0142ek-Kruk","sequence":"additional","affiliation":[{"name":"Department of Genetics, Wroclaw University of Environmental and Life Sciences, 51-631 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0439-7581","authenticated-orcid":false,"given":"Damian","family":"Kania","sequence":"additional","affiliation":[{"name":"Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4553-3479","authenticated-orcid":false,"given":"Wojciech","family":"Wola\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-1156","authenticated-orcid":false,"given":"Andrzej","family":"My\u015bliwiec","sequence":"additional","affiliation":[{"name":"Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Dowgierd","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, 10-561 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"89058","DOI":"10.3389\/fphys.2014.00163","article-title":"Evaluation and integration of disparate classification systems for clefts of the lip","volume":"5","author":"Wang","year":"2014","journal-title":"Front. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1038\/nrg2933","article-title":"Cleft lip and palate: Understanding genetic and environmental influences","volume":"12","author":"Dixon","year":"2011","journal-title":"Nat. Rev. Genet."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hlongwa, P., Levin, J., and Rispel, L.C. (2019). Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215931"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1159\/000337617","article-title":"Roles of BMP signaling pathway in lip and palate development","volume":"16","author":"Parada","year":"2012","journal-title":"Front. Oral Biol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/PRS.0b013e3182402dd1","article-title":"Updating the epidemiology of cleft lip with or without cleft palate","volume":"129","author":"Tanaka","year":"2012","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Pastuszak, P., Dunin-Wilczy\u0144ska, I., and Lasota, A. (2020). Frequency of additional congenital dental anomalies in children with cleft lip, alveolar and palate. J. Clin. Med., 9.","DOI":"10.3390\/jcm9123813"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/hmg\/ddh052","article-title":"Genetics of cleft lip and palate: Syndromic genes contribute to the incidence of non-syndromic clefts","volume":"13","author":"Stanier","year":"2004","journal-title":"Hum. Mol. Genet."},{"key":"ref_8","first-page":"22","article-title":"Factors affecting facial development and formation of cleft lip and palate: A literature review","volume":"29","author":"Vaivads","year":"2020","journal-title":"Pap. Anthr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/aje\/kwi214","article-title":"Cleft lip and palate versus cleft lip only: Are they distinct defects?","volume":"162","author":"Harville","year":"2005","journal-title":"Am. J. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1597\/07-134.1","article-title":"DNA methylation changes during cleft palate formation induced by retinoic acid in mice","volume":"45","author":"Kuriyama","year":"2008","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"272","DOI":"10.4103\/0971-6866.107973","article-title":"Small players with a big role: MicroRNAs in pathophysiology of cleft lip and palate","volume":"18","author":"Radhakrishna","year":"2012","journal-title":"Indian J. Hum. Genet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.30699\/mmlj17.4.2.40","article-title":"Evaluation of the Correlation between Socioeconomic Factors and Pediatric Cleft Lip and Palate","volume":"4","author":"Habibi","year":"2021","journal-title":"Mod. Med. Lab. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1034\/j.1399-0004.2002.610402.x","article-title":"Gene\/environment causes of cleft lip and\/or palate","volume":"61","author":"Murray","year":"2002","journal-title":"Clin. Genet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.envres.2015.06.002","article-title":"Maternal ambient air pollution exposure preconception and during early gestation and offspring congenital orofacial defects","volume":"140","author":"Zhu","year":"2015","journal-title":"Environ. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1016\/j.joms.2018.03.028","article-title":"Growth and Development of Craniofacial Structures in Patients at Different Ages with Unrepaired Submucous Cleft Palate","volume":"76","author":"Cao","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1597\/14-080","article-title":"Classification of Cleft Lip\/Palate: Then and Now","volume":"54","author":"Allori","year":"2017","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"341","DOI":"10.2307\/2669574","article-title":"Model selection and inference: A practical information-theoretic approach by Kenneth P. Burnham; David R. Anderson","volume":"95","author":"Strawderman","year":"2014","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ijom.2014.10.010","article-title":"Bilateral sagittal split osteotomy versus distraction osteogenesis of the mandible: A randomized clinical trial","volume":"44","author":"Baas","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.clp.2018.07.006","article-title":"Cleft Lip and Palate","volume":"45","author":"Worley","year":"2018","journal-title":"Clin. Perinatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e039","DOI":"10.1590\/1807-3107bor-2021.vol35.0039","article-title":"Prevalence of cleft lip and palate and associated factors in Brazil\u2019s Midwest: A single-center study","volume":"35","author":"Barros","year":"2021","journal-title":"Braz. Oral Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.annepidem.2015.05.003","article-title":"Parental age and the risk of isolated cleft lip: A registry-based study","volume":"25","author":"Berg","year":"2015","journal-title":"Ann. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/ppe.12727","article-title":"Risk of non-syndromic orofacial clefts by maternal rural-urban residence and race\/ethnicity: A population-based case-control study in Washington State 1989\u20132014","volume":"35","author":"Kapos","year":"2020","journal-title":"Paediatr. P\u00e9rinat. Epidemiol."},{"key":"ref_23","first-page":"e24","article-title":"Risk factors and comorbidities in Brazilian patients with orofacial clefts","volume":"32","author":"Arruda","year":"2018","journal-title":"Braz. Oral Res."},{"key":"ref_24","first-page":"118","article-title":"Gestational Diabetes Mellitus and the Development of Cleft Lip\/Palate in Newborns","volume":"15","author":"Kozma","year":"2019","journal-title":"Acta Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1177\/0022034513507452","article-title":"Micronutrients and Oral Clefts: A Case-Control Study","volume":"92","author":"McKinney","year":"2013","journal-title":"J. Dent. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12937-018-0420-4","article-title":"Maternal periconceptional consumption of sprouted potato and risks of neural tube defects and orofacial clefts","volume":"17","author":"Ni","year":"2018","journal-title":"Nutr. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/ppe.12123","article-title":"M; National Birth Defects Prevention Study. Maternal stressors and social support as risks for delivering babies with structural birth defects","volume":"28","author":"Carmichael","year":"2014","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"R7","DOI":"10.1677\/joe.1.06374","article-title":"Chronic maternal stress inhibits the capacity to up-regulate placental 11\u03b2-hydroxysteroid dehydrogenase type 2 activity","volume":"186","author":"Welberg","year":"2005","journal-title":"J. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1042\/cs0960513","article-title":"Glucocorticoids and insulin resistance: Old hormones, new targets","volume":"96","author":"Andrews","year":"1999","journal-title":"Clin. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1002\/tera.1420260306","article-title":"Vitamin B6 reduces cortisone-induced cleft palate in the mouse","volume":"26","author":"Yoneda","year":"1982","journal-title":"Teratology"},{"key":"ref_31","first-page":"266","article-title":"Induktion und Pr\u00e4vention von Lippen-Kiefer-Gaumen-Segel-Spalten und Neuralrohrdefekten unter besonderer Ber\u00fccksichtigung der B-Vitamine und des Methylierungszyklus","volume":"68","author":"Lotz","year":"2007","journal-title":"J. Orofac. Orthop."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e534","DOI":"10.1097\/SCS.0000000000004488","article-title":"Maternal Folic Acid Supplementation and the Risk of Oral Clefts in Offspring","volume":"29","author":"Jahanbin","year":"2018","journal-title":"J. Craniofacial Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1177\/10454411950060040601","article-title":"Prenatal Craniofacial Development: New Insights on Normal and Abnormal Mechanisms","volume":"6","author":"Johnston","year":"1995","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"272","DOI":"10.2188\/jea.JE20190347","article-title":"Population attributable fractions of modifiable risk factors for nonsyndromic orofacial clefts: A prospective cohort study from the Japan environment and children\u2019s study","volume":"31","author":"Sato","year":"2021","journal-title":"J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1002\/ajim.22731","article-title":"Maternal occupational physical activity and risk for orofacial clefts","volume":"60","author":"Agopian","year":"2017","journal-title":"Am. J. Ind. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/njms.NJMS_55_18","article-title":"Heterogeneous conceptualization of etiopathogenesis: Oral pyogenic granuloma","volume":"10","author":"Yadav","year":"2019","journal-title":"Natl. J. Maxillofac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1097\/00001648-200011000-00013","article-title":"A Prospective Study of the Risk of Congenital Defects Associated with Maternal Obesity and Diabetes Mellitus","volume":"11","author":"Moore","year":"2000","journal-title":"Epidemiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/00000637-200111000-00001","article-title":"Association Between Maternal Diabetes Mellitus and Newborn Oral Cleft","volume":"47","author":"Spilson","year":"2001","journal-title":"Ann. Plast. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0378-3782(00)00125-0","article-title":"Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes","volume":"61","author":"Westbom","year":"2001","journal-title":"Early Hum. Dev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1038\/sj.jhh.1001400","article-title":"The effect of antihypertensive drugs on the fetus","volume":"16","author":"Rosenthal","year":"2002","journal-title":"J. Hum. Hypertens."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/SCS.0000000000004214","article-title":"A Study on Environmental Factors for Nonsyndromic Cleft Lip and\/or Palate","volume":"29","author":"Xu","year":"2018","journal-title":"J. Craniofacial Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1002\/bdr2.1385","article-title":"A population-based case\u2013control study of the association between weather-related extreme heat events and orofacial clefts","volume":"110","author":"Soim","year":"2018","journal-title":"Birth Defects Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40902-020-00270-7","article-title":"Assessment of the correlation between various risk factors and orofacial cleft disorder spectrum: A retrospective case-control study","volume":"42","author":"Cheshmi","year":"2020","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1741-4520.2010.00300.x","article-title":"Efficacy of medical care of epileptic pregnant women based on the rate of congenital abnormalities in their offspring","volume":"51","author":"Czeizel","year":"2011","journal-title":"Congenit. Anomalies"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1542\/pir.23.1.17","article-title":"Effects of certain prenatal drugs on the fetus and newborn","volume":"23","author":"Boyle","year":"2002","journal-title":"Pediatr. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1002\/bdra.23570","article-title":"Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011","volume":"106","author":"Ailes","year":"2016","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S8756-5005(09)79161-9","article-title":"Antibacterial Medication Use During Pregnancy and Risk of Birth Defects: National Birth Defects Prevention Study","volume":"2010","author":"Benitz","year":"2010","journal-title":"Yearb. Neonatal P\u00e9rinat. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/EDE.0b013e318258cb05","article-title":"Maternal Exposure to Amoxicillin and the Risk of Oral Clefts","volume":"23","author":"Lin","year":"2012","journal-title":"Epidemiology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1002\/bdra.10134","article-title":"First trimester exposure to corticosteroids and oral clefts","volume":"67","author":"Pradat","year":"2003","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/S0140-6736(05)60824-0","article-title":"Fetal exposure to maternal cortisol","volume":"352","author":"Gitau","year":"1998","journal-title":"Lancet"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jaad.2009.09.041","article-title":"Systematic review of the safety of topical corticosteroids in pregnancy","volume":"62","author":"Chi","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"405.e1","DOI":"10.1016\/j.ajog.2012.07.008","article-title":"Use of topiramate in pregnancy and risk of oral clefts","volume":"207","author":"Margulis","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"462","DOI":"10.3389\/fped.2020.00462","article-title":"Prenatal Exposures Are Associated with Worse Neurodevelopmental Outcomes in Infants with Neonatal Opioid withdrawal Syndrome","volume":"8","author":"Benninger","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1177\/10556656211040015","article-title":"Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis","volume":"59","author":"Fell","year":"2021","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/oxfordjournals.aje.a010071","article-title":"Maternal cigarette smoking during pregnancy and risk of oral clefts in newborns","volume":"150","author":"Lieff","year":"1999","journal-title":"Am. J. Epidemiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/ppe.12131","article-title":"Maternal Alcohol Consumption during Pregnancy and the Risk of Orofacial Clefts in Infants: A Systematic Review and Meta-Analysis","volume":"28","author":"Bell","year":"2014","journal-title":"Paediatr. P\u00e9rinat. Epidemiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ijom.2012.10.008","article-title":"Current concepts on the effect of environmental factors on cleft lip and palate","volume":"42","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/0194599820944899","article-title":"Cleft Lip and Palate in Newborns Diagnosed with Neonatal Abstinence Syndrome","volume":"164","author":"Danis","year":"2020","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Inchingolo, A.M., Fatone, M.C., Malcangi, G., Avantario, P., Piras, F., Patano, A., Di Pede, C., Netti, A., Ciocia, A.M., and De Ruvo, E. (2022). Modifiable Risk Factors of Non-Syndromic Orofacial Clefts: A Systematic Review. Children, 9.","DOI":"10.3390\/children9121846"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1016\/S0140-6736(09)60695-4","article-title":"Cleft lip and palate","volume":"374","author":"Mossey","year":"2009","journal-title":"Lancet"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1177\/1465312518823010","article-title":"Orthodontic burden of care for patients with a cleft lip and\/or palate","volume":"46","author":"Hameed","year":"2019","journal-title":"J. Orthod."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s00268-009-0333-7","article-title":"Cleft lip and palate as a cost-effective health care treatment in the developing world","volume":"34","author":"Magee","year":"2010","journal-title":"World J. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/ng.580","article-title":"A genome-wide association study of cleft lip with and without cleft palate identifies risk variants near MAFB and ABCA4","volume":"42","author":"Beaty","year":"2010","journal-title":"Nat. Genet."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/399\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:19:47Z","timestamp":1760105987000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":63,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["children11040399"],"URL":"https:\/\/doi.org\/10.3390\/children11040399","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]}}}