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Quality of life in early age Spanish children treated for cleft lip and/or palate: a case-control study approach
Manuel Leopoldo-Rodado1, Fatima Pantoja-Pertegal2, Rodolfo Belmonte-Caro3
1Department of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain.
Insights
Children treated for cleft lip/palate (CL/P) experience poorer health-related quality of life (HRQoL) in early childhood compared to healthy peers. This impacts psychological and functional dimensions, with parents reporting worse outcomes.
Area of Science:
- Pediatric Health
- Quality of Life Research
- Craniofacial Anomalies
Background:
- Cleft lip and/or palate (CL/P) affects children's development and well-being.
- Understanding health-related quality of life (HRQoL) in young CL/P patients is crucial for comprehensive care.
- Early childhood is a critical period for assessing the long-term impact of CL/P treatment.
Purpose of the Study:
- To evaluate HRQoL in 4-7-year-old children treated for CL/P compared to healthy controls.
- To identify associations between HRQoL and cleft type, gender, age, and surgical interventions.
- To compare HRQoL perceptions between children with CL/P and their parents.
Main Methods:
- 171 children with CL/P and 186 healthy controls (ages 4-7) participated.
- HRQoL assessed using Kiddy-KINDL (child-reported) and KINDL-p (parent-reported) questionnaires.
- COHIP-14 questionnaire used for children with CL/P and controls.
Main Results:
- Children with CL/P showed similar Kiddy-KINDL scores to controls, except for self-esteem.
- COHIP-14 scores were significantly lower in the CL/P group across all dimensions.
- Parents reported significantly worse HRQoL scores compared to their children.
Conclusions:
- Surgically treated CL/P negatively impacts early childhood HRQoL.
- Psychological and functional dimensions are significantly affected by cleft lip and palate, respectively.
- HRQoL assessments provide valuable insights for clinical decision-making and parental support in CL/P management.
Objective:
The objectives of this study were to evaluate health-related quality of life (HRQoL) in 4-7-year-old children treated for cleft lip and/or palate (CL/P) compared to healthy controls and to estimate a possible association with cleft type, gender, age, and surgical re-interventions.
Materials And Methods:
A total of 171 children with CL/P (mean age 5.7 years) and 186 healthy controls (mean age 5.5 years) were included in the study. Sixty-four (37.4%) children experienced both cleft lip and palate, 56 (32.8%) cleft lip only, and 51 (29.8%) cleft palate only. HRQoL in children was assessed by Kiddy-KINDL and COHIP-14 questionnaires and in parents by KINDL-p. Total score and dimensions of each questionnaire were compared between cleft children, their parents, and controls.
Results:
The total scores and dimension scores of Kiddy-KINDL showed similar values between CL/P and control groups, except for "self-esteem" dimension (p = 0.036). The comparison of Kiddy-KINDL and KINDL-p showed a statistically significant total score (82.11 vs. 80.44, p = 0.047). The CL/P group presented significantly worse values with respect to controls in total score of COHIP-14 (10.53 vs 5.01, p < 0.001) and in all its dimensions.
Conclusions:
Children treated for CL/P had a negative impact on HRQoL at early age compared to controls. Significant differences were found in the psychological and functional dimensions related to lip and palatal affectation, respectively. Parents reported significantly worse scores than their children. HRQoL measurement provided valuable complementary information to better inform to parents and make clinical decisions in children with CL/P at early age.
Clinical Relevance:
Our findings suggested that Spanish children between 4 and 7 years of age with a history of surgically treated CL/P experienced a poorer HRQoL when compared with their non-cleft peers.
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