Orofacial Clefts in High Prevalence Area of Birth Defects — Five Counties, Shanxi Province, China, 2000–2020

WHAT IS ALREADY KNOWN ON THIS TOPIC? The prevalence of structural birth defects, especially neural tube defects, decreased after national folic acid (FA) supplementation initiation. WHAT IS ADDED BY THIS REPORT? The prevalence of orofacial clefts (OFCs) in five counties of Shanxi Province in northern China, including most subtypes except cleft palate, showed a downward trend in the past two decades. In this study, pre-perinatal prevalence increased due to earlier detection. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? Periconceptional supplementation with FA may contribute to the decline in OFCs prevalence, while the effect on the OFCs subtype needs further investigation. Continuing to advocate for earlier supplementation (3 months before conception) and increased supplementation frequency (daily consumption) could promote further reduction in the prevalence of OFCs. Specific surveillance of this effect in the era of universal three-child policy is warranted.