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Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts

Karin K Tillman1, Malin Hakelius1, Jonas Höijer2

  • 1Uppsala University, Sweden.

Journal of the American Academy of Child and Adolescent Psychiatry
|November 6, 2018
PubMed

Insights

Children with orofacial clefts (OFC) face a higher risk of psychiatric and neurodevelopmental disorders, independent of family factors. This includes conditions like autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD).

Area of Science:

  • Pediatric Psychiatry
  • Genetics
  • Public Health

Background:

  • Orofacial clefts (OFC) are associated with potential mental health challenges in children.
  • Understanding the specific psychiatric risks stratified by cleft type is crucial for early intervention.

Purpose of the Study:

  • To investigate the risk of psychiatric diagnoses in individuals with nonsyndromic orofacial clefts.
  • To stratify these risks based on specific cleft types (CL, CLP, CPO).

Main Methods:

  • Nationwide Swedish cohort study (1973-2012) comparing individuals with OFC to matched controls and unaffected siblings.
  • Cox regression models were used to analyze risks for psychiatric diagnoses, suicide attempts, and suicides.
  • Effect modification by sex was examined.

Main Results:

  • Individuals with cleft lip (CL) showed increased risks for psychiatric disorders, intellectual disability, and language disorders.
  • Cleft lip and palate (CLP) additionally presented higher risks for autism spectrum disorder (ASD).
  • Cleft palate only (CPO) exhibited elevated risks for psychotic disorders, ADHD, and behavioral issues, with higher hazard ratios compared to CL and CLP.

Conclusions:

  • Nonsyndromic clefts significantly increase the risk for neurodevelopmental disorders.
  • Familial influences, such as genetic or shared environmental factors, are unlikely to fully explain this elevated risk.
  • The findings highlight a distinct risk profile for psychiatric conditions in individuals with OFC.
Abstract

Keywords:
epidemiologyneurodevelopmental disordersnonsyndromic cleftspsychiatric comorbidity

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