Abstract：
OBJECTIVE: To characterize incidence of mandibular anomalies (MAs) and compare gestational age, airway interventions, and complications among individuals with MA phenotypes (isolated retrognathia, isolated micrognathia, syndromic micrognathia, micrognathia plus cleft palate/cleft lip and palate, agnathia/micrognathia plus cervical auricle/otocephaly, and agnathia/micrognathia plus microstomia) and unaffected individuals.
METHODS: The Healthcare Cost and Utilization Project Kids\' Inpatient Database was used to collect data over a 20-year period beginning in 2000. Interventions were classified as perinatal when performed on day of life (DOL) 0 or 1 and subsequent when performed during the birth hospitalization after DOL 1. Hypoxic complications included cardiac arrest, birth asphyxia, hypoxic-ischemic encephalopathy, anoxic brain damage, intraventricular hemorrhage or cerebral infarction. Descriptive statistics are reported, and the Rao-Scott chi-square test compared groups.
RESULTS: MAs affected 119 per 100,000 birth visits. Preterm delivery was more frequent for all MA phenotypes. Individuals with MA phenotypes are more likely to require medical attention (airway intervention on DOL 0 or 1 OR no airway intervention received but patient sustained hypoxic complication/mortality): 16.2%-70.7% vs. 3.8%, p < 0.01. Despite receipt of airway interventions at a higher rate, collectively individuals with MAs who received an airway intervention on DOL 0 or 1 have a mildly elevated risk of hypoxic complication or mortality (32.4% vs. 26.4%, p < 0.01).
CONCLUSIONS: Preterm birth is more common, however, does not account for the elevated rate of airway intervention. Individuals with MAs require higher rates of medical attention, and current airway management paradigms are insufficient to prevent complications and mortality.
METHODS: III Laryngoscope, 2024.
METHODS: The Healthcare Cost and Utilization Project Kids\' Inpatient Database was used to collect data over a 20-year period beginning in 2000. Interventions were classified as perinatal when performed on day of life (DOL) 0 or 1 and subsequent when performed during the birth hospitalization after DOL 1. Hypoxic complications included cardiac arrest, birth asphyxia, hypoxic-ischemic encephalopathy, anoxic brain damage, intraventricular hemorrhage or cerebral infarction. Descriptive statistics are reported, and the Rao-Scott chi-square test compared groups.
RESULTS: MAs affected 119 per 100,000 birth visits. Preterm delivery was more frequent for all MA phenotypes. Individuals with MA phenotypes are more likely to require medical attention (airway intervention on DOL 0 or 1 OR no airway intervention received but patient sustained hypoxic complication/mortality): 16.2%-70.7% vs. 3.8%, p < 0.01. Despite receipt of airway interventions at a higher rate, collectively individuals with MAs who received an airway intervention on DOL 0 or 1 have a mildly elevated risk of hypoxic complication or mortality (32.4% vs. 26.4%, p < 0.01).
CONCLUSIONS: Preterm birth is more common, however, does not account for the elevated rate of airway intervention. Individuals with MAs require higher rates of medical attention, and current airway management paradigms are insufficient to prevent complications and mortality.
METHODS: III Laryngoscope, 2024.
摘要：
目的：描述下颌骨畸形（MAs）的发生率并比较胎龄，气道干预,和MA表型个体的并发症(孤立性回颌畸形，孤立的小颌畸形，综合征性小颌畸形,小颌畸形加上腭裂/唇腭裂，失调症/小颌症加颈耳廓/头目，和无能/小颌畸形加小口）和未受影响的个体。
方法：医疗成本和利用项目儿童住院数据库用于收集从2000年开始的20年期间的数据。在生命日（DOL）0或1天进行的干预被归类为围产期，在DOL1之后的分娩住院期间进行的干预被归类为围产期。缺氧并发症包括心脏骤停，出生窒息,缺氧缺血性脑病,缺氧脑损伤,脑室内出血或脑梗塞。报告了描述性统计数据，Rao-Scott卡方检验比较各组。
结果：MAs影响了每100,000次出生访问119次。所有MA表型的早产更频繁。具有MA表型的个体更可能需要医疗护理（DOL0或1的气道干预或未接受气道干预，但患者持续缺氧并发症/死亡率）：16.2％-70.7％vs.3.8%,p<0.01。尽管接受了较高的气道干预率，接受DOL0或1气道干预的MAs患者的低氧并发症或死亡率风险轻度升高(32.4%vs.26.4%,p<0.01)。
结论：早产更常见，然而,并不能解释气道干预率的升高。拥有MA的个人需要更高的医疗护理率，目前的气道管理模式不足以预防并发症和死亡.
方法：III喉镜，2024.
方法：医疗成本和利用项目儿童住院数据库用于收集从2000年开始的20年期间的数据。在生命日（DOL）0或1天进行的干预被归类为围产期，在DOL1之后的分娩住院期间进行的干预被归类为围产期。缺氧并发症包括心脏骤停，出生窒息,缺氧缺血性脑病,缺氧脑损伤,脑室内出血或脑梗塞。报告了描述性统计数据，Rao-Scott卡方检验比较各组。
结果：MAs影响了每100,000次出生访问119次。所有MA表型的早产更频繁。具有MA表型的个体更可能需要医疗护理（DOL0或1的气道干预或未接受气道干预，但患者持续缺氧并发症/死亡率）：16.2％-70.7％vs.3.8%,p<0.01。尽管接受了较高的气道干预率，接受DOL0或1气道干预的MAs患者的低氧并发症或死亡率风险轻度升高(32.4%vs.26.4%,p<0.01)。
结论：早产更常见，然而,并不能解释气道干预率的升高。拥有MA的个人需要更高的医疗护理率，目前的气道管理模式不足以预防并发症和死亡.
方法：III喉镜，2024.
