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General body growth in children with cleft palate and related disorders: age differences
E J Bowers1, R F Mayro, L A Whitaker
1Facial Reconstruction Center, Childrens Hospital of Philadelphia, Pennsylvania 19104.
Insights
Children with cleft lip and palate may experience altered growth. This study found growth status differences associated with age, sex, and cleft type in children with unilateral cleft lip and palate (uCLP) and isolated cleft palate (iCP).
Area of Science:
- Pediatric endocrinology
- Congenital anomaly research
- Genetics and developmental biology
Background:
- Cleft lip and palate are common congenital defects with complex, potentially hormonal, etiologies.
- Previous research indicated a link between growth status and cleft type.
- The impact of these conditions on overall child growth remains incompletely understood.
Purpose of the Study:
- To investigate whether children with cleft lip and palate exhibit altered growth patterns.
- To examine the association between growth status and specific diagnoses (unilateral cleft lip and palate, isolated cleft palate).
- To explore age and sex differences in growth deficits within this population.
Main Methods:
- Cross-sectional analysis of height and body mass index (BMI) z-scores.
- Study included 144 children diagnosed with unilateral cleft lip and palate (uCLP) or isolated cleft palate (iCP).
- Statistical examination of growth status in relation to age group, sex, and diagnosis.
Main Results:
- Growth status alterations were found to be significantly associated with age group.
- Sex and diagnosis (uCLP vs. iCP) also showed significant associations with growth status.
- The findings suggest a complex interplay of factors influencing growth in children with clefts.
Conclusions:
- Growth deficits in children with cleft lip and palate are influenced by age, sex, and the specific type of cleft.
- These findings support the hypothesis that genetic factors affecting metabolic pathways may impact both prenatal and postnatal growth.
- Further research into hormonal and genetic factors is warranted to understand and manage growth disturbances in affected children.
Abstract:
Clefts of the lip and palate, separately or in combination, are among the most frequent congenital defects seen today. Their etiology is heterogeneous and may include hormonal factors, which suggest the possibility of growth effects. Whether affected children are smaller than others has not been determined. We recently showed that growth status is associated with type of cleft. We hypothesized genetic alterations in metabolic pathways that alter prenatal growth, producing clefts; some of these alterations also alter postnatal growth. Since the levels of growth-regulating hormones change during ontogeny, we expected age differences in the degree of growth deficit seen. To test this hypothesis, we examine here the cross-sectional means and distributions of standard deviation (z) scores for height and body mass indices (BMIs) for 144 children with the diagnoses unilateral cleft lip and palate (uCLP) and isolated cleft palate (iCP). We find that alteration in growth status is associated with age group as well as sex and diagnosis.