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Do psychosocial variables predict the physical growth of infants with orofacial clefts?
1University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle 98105, USA.
Insights
Psychosocial factors significantly impact early infant growth with orofacial clefts, but biological factors become more dominant later. This research highlights early intervention importance for these infants.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Craniofacial Biology
Background:
- Infants with orofacial clefts often experience growth challenges.
- Understanding factors influencing growth is crucial for intervention.
- Previous research has focused primarily on medical aspects.
Purpose of the Study:
- To investigate the predictive role of psychosocial variables on infant growth with orofacial clefts.
- To differentiate growth trajectories between cleft lip and palate (CLP) and cleft palate only (CPO) infants.
- To assess the influence of psychosocial factors after controlling for medical variables.
Main Methods:
- Longitudinal study tracking infant growth (weight-to-height z-scores) for 2 years.
- Development of predictive models for growth at 3, 12, and 24 months.
- Inclusion of psychosocial variables (feeding interactions, temperament, social support, socioeconomic status) and medical variables (health status, cleft type, previous weight).
Main Results:
- Psychosocial variables accounted for 42% of growth variance at 3 months, controlling for medical factors.
- Cleft palate only (CPO) infants showed improved growth over time relative to the population mean.
- Cleft lip and palate (CLP) infants exhibited consistently lower growth than the population mean.
- The influence of psychosocial variables on growth diminished at 12 and 24 months, with previous growth being a stronger predictor.
Conclusions:
- Psychosocial factors play a significant role in the initial growth trajectory of infants with orofacial clefts.
- Biological factors, particularly prior growth, become increasingly dominant in regulating growth beyond the early months.
- Findings suggest the importance of early psychosocial support for infants with clefts.
Abstract:
This study sought to determine whether psychosocial variables (parent-infant feeding interactions, infant temperament, maternal social support, family socioeconomic status) are important in predicting the physical growth of infants with orofacial clefts, after controlling for selected medical variables (infant health status, cleft diagnosis, and previous weight). Infant growth (weight-to-height zscores) was tracked for 2 years, and models were developed to predict growth at 3, 12, and 24 months. The authors also examined the growth trajectories of infants with different cleft types: cleft lip and palate (CLP) and cleft palate only (CPO). CPO infants showed some increase in their growth relative to the population mean over time, whereas the growth of CLP infants remained lower than the population mean at all time points. After controlling for medical variables, psychosocial variables collectively accounted for an additional 42% of the variance in infants' growth at 3 months of age, but they did not account for growth at 12 months and 24 months, largely due to the strong effect of previous growth. The authors tentatively conclude that psychosocial variables influence the early growth trajectory of infants with clefts, but subsequent growth becomes increasingly regulated by biological factors.