Estudo epidemiológico multicêntrico de fissuras palatinas isoladas e avaliação dos níveis de ansiedade, depressão, estresse e medo da morte na pandemia da COVID-19 em pais e/ou cuidadores de crianças com fissuras orais

Abstract

This work list two studies with the objectives of to describe the epidemiological findings of patients with isolated cleft palate (CP) treated at four Specialized Centers, Brazil, and to assess the anxiety, depression, stress and fear levels in parents and caregivers of children with nonsyndromic oral clefts (NSOC). The first is a multicenter study, conducted from November 2021 to June 2022. Participants with CP attended by the services were included. Clinical and sociodemographic variables were measured, and the presence of the parents and/or mother was necessary, due questions related to the gestational period were collected. The second is a convenience case-control study, conducted in a specialized center located in Minas Gerais. The depression, anxiety and stress scale (DASS-21), the Collett-Lester fear of death scale (CLFODS) and the fear of COVID-19 scale (FC-19s) were used to assess symptoms of anxiety, depression, stress and fear of parents and caregivers of children with NSOC. Control group was recruited at the pediatric dentistry clinic of the same institution where the case group was collected. Both study data were tabulated in the IBM Statistical Package for the Social Sciences (SPSS) version 22.0 program for statistical treaties and were approved by the Ethics and Research Committee. In the first study, 313 individuals from the states of Bahia, Minas Gerais and Paraná participated. Majority were female (58.1%), white (60.7%), with incomplete CP (61.2%) and mean age of 13.4 years. More than half of the sample had already undergone dental care (64.7%) and/or some surgical procedure (67.9%) and 40.6% of the participants had some type of systemic alteration. An association was identified between complete CP and a positive history of medical problems during pregnancy (p=0.016; 27.9%; OR: 1.94; 1.12-3.35). Higher age groups were associated with the chance of undergoing dental care and surgical treatment (p<0.050). In the second study, 210 individuals participated, 38.1% were parents and/or caregivers of children with NSOC and 61.9% from the control group. Majority were mothers of children (80.5%), with a partner (65.2%) and over 30 years old (67.6%). Anxiety, depression and severe stress were more frequent in the case group (8.8%, 12.5% and 17.5%, respectively), with a higher OR. The mean of the level of fear of death was higher in the group case (83.8 compared to 82.4 in the control group). However, there were no statistical associations between groups regarding differences in these symptoms. Higher scores of fear of COVID-19 were more present and associated with the control group (p=0.029; 43.8%; OR: 0.51; 0.28-0.93). It is concluded that among the CP, the incomplete one is the most common and most prevalent in Caucasian females. Medical problems during pregnancy may be predictive of the etiogenesis of complete CP. Parents and caregivers of children with NSOC showed a slight predilection for more severe levels of anxiety, depression and stress and slightly higher levels of fear of death, but lower fear of COVID-19.