Objective: To investigate the association between periconceptional environmental exposures and the occurrence of cleft lips and palates. Methods: This case-control study analyzed 150 mothers of children with cleft lips and palates living in the same city as 250 mothers whose children did not present with this malformation (controls). Environmental exposure data were gathered through a questionnaire (Latin American Collaborative Study of Congenital Malformations methodology). Results: Multivariate analysis revealed that monthly income below minimum wage, having another malformed child, other diseases in the first gestational trimester (urinary infection), use of pesticides in home gardens, and pesticide use in farms close to the home were risk factors associated with the malformation, whereas taking vitamins was a protective factor. Conclusion: Maternal and paternal exposure to pesticides is associated with cleft lip and palate in Mato Grosso State, Brazil.

As anomalias craniofaciais representam um grupo amplo de malformações congênitas que afetam uma grande proporção da sociedade mundial. Entre essas se encontram as fissuras de lábio e/ou de palato, anomalia orofacial mais frequente entre os seres humanos que ocasionam problemas estéticos e funcionais nos indivíduos afetados.  A etiologia das fissuras labiopalatinas isoladas ou não-sindrômicas é complexa e multifatorial, associadas à fatores hereditários e ambientais. Este estudo teve como objetivo relatar os fatores genéticos e ambientais associados à etiologia desse tipo de malformação, através de uma revisão narrativa de literatura, a partir das bases de dados: PubMed e Scielo. Os descritores utilizados foram: cleft palate AND cleft lip AND etiology AND risk factors. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos nacionais e internacionais acerca da temática da pesquisa. Baseado na revisão de literatura se pode identificar que os fatores ambientais como: fumo, consumo de álcool, consumo de medicamentos, o não uso de suplementação com polivitamínicos e ácido fólico, exposição a agrotóxicos, idade dos genitores podem aumentar a chance de ocorrência das fissuras labiopalatinas. O acompanhamento gestacional durante o primeiro trimestre gestacional se faz necessário, a fim de monitorar os fatores de risco associados com as fissuras labiopalatinas não sindrômicas.   Palavras-chave: Fissura Palatina. Fenda Labial. Etiologia. Fatores de Risco.   Abstract Craniofacial anomalies represent a broad group of congenital malformations that affect a large proportion of world society. Among them are cleft lip and / or palate, the most frequent orofacial anomaly among human beings that cause aesthetic and functional problems in the affected individuals. The etiology of isolated or non-syndromic cleft lip and palate is complex and multifactorial, associated with hereditary and environmental factors. This study aimed to report the genetic and environmental factors associated with the etiology of this type of malformation through a narrative literature review conducted in October 2020, using the PubMed and Scielo databases. The keywords used were cleft palate AND cleft lip AND etiology AND risk factors. Articles in English and Portuguese published in national and international journals about the research theme were included. Based on the literature review, it can be identified that environmental factors such as smoking, alcohol consumption, medication consumption, the non-use of supplementation with multivitamins and folic acid, exposure to pesticides, age of parents can increase the chance of cleft lip and palate occurrence. Gestational monitoring during the first trimester of pregnancy is necessary in order to monitor the risk factors associated with non-syndromic cleft lip and palate.   Keywords: Cleft Palate. Cleft Lip. Etiology. Risk Factors.

Introduction: Studies associate human exposure to pesticides with congenital malformations, including cleft lip and palate. Objectives: to estimate the association between maternal exposure to pesticides and cleft lip and palatein children aged 0 to 5 years living in the state capital of agribusiness from January to November 2019. Method: a control case study performed with the fathers of children with cleft lip and palate (cases) and fathers without children with malformations (controls). Information was obtained regarding the diagnosis of malformation from the records of the Rehabilitation Service of Labiopalatine Fissures of the General Hospital of Cuiabá. Socioeconomic information on environmental and occupational exposure was obtained through the application of a standardized questionnaire. The cases and controls were matched by age and gender. The 95% confidence interval was considered, estimated exposure frequency of the controls of 40%, a ratio of 1:4 controls and significant Odds Ratio of 2.4. The final sample resulted in 58 mothers of children with cleft lip and palate (case group) and 232 mothers of children without malformations (control group). Results: The variables associated with cleft lip and palate were: prematurity (OR= 6.05; CI95% = 1.24 -29.53), mother's occupation when she became pregnant (OR= 1.90; CI95% = 1.02 - 3.52), previous home of the mother in rural areas (OR= 2.08; CI95% = 1.01 - 4.27). Conclusion: mothers who reported premature delivery, occupation not being from the home when pregnant and living in a rural area before becoming pregnant were conditions associated with the occurrence of cleft lip and palate in children up to 5 years of age in Greater Cuiabá.

A fissura de lábio e ou de palato não sindrômicas são anomalias congênitas craniofaciais mais frequentes. Elas ocasionam problemas estéticos e funcionais que requerem tratamento em longo prazo, envolvendo reabilitação multidisciplinar incluindo a fonoaudiologia e fisioterapia. Este estudo propõem apresentar alguns dos princípios de atuação do fonoaudiólogo e do fisioterapeuta nas fissuras orofaciais não sindrômicas. Realizou-se uma revisão de literatura narrativa com busca na Bireme e Scielo e nas bases Lilacs, Pedro e  PubMed em outubro de 2020, envolvendo a atuação do  fonoaudiólogo e do fisioterapeuta nas fissuras orofaciais não sindrômica, no idioma inglês e português, sem recorte temporal. Os estudos encontrados observaram que a intervenção fonoaudiológica e fisioterapêutica deve ser mais precoce e de acordo com a disfunção apresentada. De modo geral, a atuação do fonoaudiólogo favorece a alimentação oral  e o desenvolvimento global referente à linguagem, a fala, audição e neuropsicomotor, para evitar atrasos e favorecer o melhor desenvolvimento infantil. A atuação fisioterapêutica visa diminuir a hospitalização prolongada, melhorar a qualidade de vida e funcionalidade, bem como assistir as crianças que cursarem com problemas motores, posturais e respiratórios. Conclui-se que a atuação fonoaudiológica nas diferentes fases da reabilitação de indivíduos com fissuras labiopalatinas contribui para alimentação e inteligibilidade da fala, beneficiando assim a comunicação verbal e consequentemente a interação com o meio social; e a assistência fisioterapêutica ajuda e melhorar a sintomatologia e as disfunções respiratórias apresentadas, prevenindo e tratando complicações de forma a melhorar a qualidade de vida e restabelecer a independência funcional.   Palavras-chave: Fissura Palatina. Fenda Labial. Aleitamento Materno. Fala. Fisioterapia.   Abstract Non-syndromic cleft lip and or palate are the most frequent congenital craniofacial anomalies. They cause aesthetic and functional problems that require long-term treatment, involving rehabilitation including speech therapy and physiotherapy. This study proposes to present some of the principles of performance of the speech therapist and physiotherapist in non-syndromic orofacial clefts. A narrative literature review was carried out with searches in Bireme and Scielo and in the Lilacs, Pedro and PubMed databases in October 2020, involving the performance of the speech therapist and physiotherapist in non-syndromic orofacial clefts, in English and Portuguese, with no time frame. The studies observed that speech therapy and physiotherapy intervention should be as earlier and in accordance with the presented dysfunction. In general, the performance of the speech therapist favors oral feeding and the global development related to language, speech, hearing and neuropsychomotor, to avoid delays and favor best child development. Physiotherapeutic action aims to reduce the prolonged hospitalization, improve quality of life and functionality, as well as assist children who are experiencing motor, postural and respiratory problems. It is concluded that the speech therapy performance in the different phases of rehabilitation of individuals with cleft lip and palate contributes to feeding and speech intelligibility, thus benefiting verbal communication and consequently the interaction with the social environment; and physiotherapeutic assistance helps and improves the symptoms and respiratory disorders presented, preventing and treating complications in order to improve the quality of life and restore functional independence.   Keywords: Cleft Palate. Cleft Lip. Breast Feeding. Speech. Physiotherapy.