RESUMO
OBJECTIVE: To describe trends, age-specific patterns, and factors influencing hospitalizations for 5 rare craniofacial anomalies (CFAs). METHODS: Data on livebirths (1983-2010; n = 721â019) including rare CFA (craniofacial microsomia, mandibulofacial dysostosis, Pierre Robin sequence, Van der Woude syndrome, and frontonasal dysplasia), episodes of death, and demographic and perinatal factors were identified from the Western Australian Register of Developmental Anomalies, Death Registrations and Midwives Notification System. Information on incident craniofacial and noncraniofacial related admissions, length of hospital stay, and intensive care and emergency-related admissions were identified using principal diagnosis and procedural codes were extracted from the Hospital Morbidity Data Collection and linked to other data sources. Associations of hospitalizations by age groups as well as demographic and perinatal factors were expressed as incidence rate ratio (IRR). RESULTS: The incident hospitalizations were 3 times as high for rare CFA (IRR 3.22-3.72) throughout childhood into adolescence than those without. Children with rare CFA had 3-4 times as many potentially preventable hospitalizations until 18 years of age than those without. Specifically, respiratory infections (IRR 2.13-2.35), ear infections (IRR 7.92-26.28), and oral health-related conditions contributed for most noncraniofacial admissions until the adolescence period. A greater incidence of noncraniofacial related hospitalizations was observed among Indigenous children, births with intrauterine growth restrictions, and families with high socioeconomic disadvantage. CONCLUSIONS: Throughout childhood, individuals with rare CFA had greater hospital service use, specifically for potentially preventable conditions, than those without. These population-level findings can inform new preventive strategies and early disease management targeted toward reducing preventable hospitalizations.
Assuntos
Fissura Palatina , Hospitalização , Criança , Gravidez , Feminino , Adolescente , Humanos , Austrália Ocidental/epidemiologia , Austrália/epidemiologia , Tempo de InternaçãoRESUMO
OBJECTIVE: To describe birth prevalence of rare craniofacial anomalies and associations with antenatal and perinatal factors. STUDY DESIGN: All live and stillbirths in Western Australia between 1980 and 2010 were identified from the Western Australian Birth Registrations and the Midwives Notification System (also provides information on antenatal and perinatal factors). Rare craniofacial anomalies (craniosynostosis, craniofacial microsomia, and others [Pierre Robin, Van der Woude, and Treacher Collins syndrome]) were ascertained from the Western Australian Register of Developmental Anomalies and linked to other data sources. Trends in prevalence, adjusted for sex and Indigenous status, were investigated by Poisson regression and presented as annual percent change (APC). Strengths of association of related factors were assessed using multivariable log-binomial regression adjusted for sex, Indigenous status, birth year, socioeconomic disadvantage, and remoteness and reported as risk ratios with 95% CIs. RESULTS: There was a temporal increase in prevalence of metopic synostosis (APC 5.59 [2.32-8.96]) and craniofacial microsomia (Goldenhar syndrome) (APC 4.43 [1.94-6.98]). Rare craniofacial anomalies were more likely among infants born preterm, as twins or greater-order multiples, with growth restriction, to older parents, to mothers undertaking fertility treatments, and with pre-existing medical conditions, specifically epilepsy, diabetes, or hypothyroidism. Prenatal identification of rare craniofacial anomalies was uncommon (0.6%). CONCLUSIONS: Our findings indicate a steady increase over time in prevalence of metopic synostosis and craniofacial microsomia (Goldenhar syndrome). Possible associations of fertility treatments and pre-existing maternal medical conditions with rare craniofacial anomalies require further investigation.
Assuntos
Anormalidades Craniofaciais/epidemiologia , Anormalidades Craniofaciais/etiologia , Feminino , Humanos , Recém-Nascido , Armazenamento e Recuperação da Informação , Masculino , Prevalência , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Austrália Ocidental/epidemiologiaRESUMO
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Adolescente , Distribuição por Idade , Criança , Índice CPO , Assistência Odontológica para Crianças/estatística & dados numéricos , Feminino , Serviços de Saúde do Indígena/estatística & dados numéricos , Humanos , Masculino , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Fatores Socioeconômicos , VitóriaRESUMO
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
O objetivo deste estudo foi investigar as características sociodemográficas de usuários do serviço público de saúde bucal no Estado de Vitória, Austrália, com até 17 anos de idade. O presente estudo é uma análise de dados secundários de 45.728 sujeitos que recorreram ao serviço público de saúde bucal entre julho de 2008 a junho de 2009. A idade média da amostra foi 8,9 (DP: 3,5) anos. A maioria dos sujeitos (82,7%) apresentava entre 6 e 17 anos de idade e 50,3% eram do gênero masculino. A maioria (76,6%) havia nascido na Austrália e falava inglês em casa (89,1%). O índice CPOD médio foi 1,0 (DP: 2,1) e o ceod 3,16 (DP: 5,79). Os dados indicam que entre as crianças de 6 anos categorizadas no Significant Caries Index (SiC), o índice ceod médio foi 6,82. Os achados demonstram desigualdade social nos desfechos de saúde bucal e fornecem sugestões para que os serviços de saúde bucal desenvolvam estratégias e prioridades para reduzir tais desigualdades na saúde e bem-estar, de forma a adequar os serviços às necessidades locais.
El objetivo de este estudio fue describir las características sociodemográficas de la población de usuarios de los servicios públicos de atención odontológica, de 17 o menos años de edad, en el estado australiano de Victoria. El estudio realiza un análisis secundario de los datos de 45.728 pacientes que asistieron a los servicios de atención odontológica públicos entre julio 2008 y junio 2009. El promedio de edad de la muestra fue 8,9 (s.d. 3,5) años. La mayoría (82,7 %) tenía entre 6 y 17 años de edad, y el 50,3 % fue de sexo masculino. La mayoría (76,6%) nació en Australia y hablaba inglés en casa (89,1%). El COPD promedio fue 1.0 (s.d. 2.1) dientes, con un ceod promedio de 3,16 (s.d. 5,79) dientes. A los 6 años de edad en la categoría de Índice de Caries Significativo, el dmft promedio fue de 6.82 dientes. Los resultados confirman desigualdades sociales en salud bucodental y proporcionan sugerencias para los servicios de salud bucodental, con el fin de desarrollar estrategias y prioridades tendientes a la reducción de desigualdades en salud y bienestar.