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Congenital heart defects in orofacial cleft: A prospective cohort study
Olufemi A Erinoso1, Olutayo James2, Ogochukwu J Sokunbi3
1Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Lagos, Nigeria.
Insights
Congenital heart defects (CHDs) affect 30.7% of patients with orofacial clefts (OFCs). No significant association was found between OFC type and CHD risk, but cardiac evaluation is recommended for all OFC patients.
Area of Science:
- Medical Research
- Pediatric Cardiology
- Genetics and Developmental Biology
Background:
- Orofacial clefts (OFCs) are frequently associated with congenital heart defects (CHDs).
- Limited data exists on the association between specific cleft types and CHDs in Nigerian populations.
- This study investigates CHD prevalence and risk factors in OFC patients within a Nigerian tertiary healthcare setting.
Purpose of the Study:
- To determine the prevalence of CHDs in a cohort of Nigerian patients with OFCs.
- To evaluate the association between the type of OFC and the risk of developing CHDs.
- To inform clinical management and screening protocols for OFC patients.
Main Methods:
- Prospective study design involving consecutive enrollment of OFC patients.
- Comprehensive cardiac assessment including echocardiography by a pediatric cardiologist.
- Categorization of patients based on CHD presence and OFC phenotypic type (e.g., cleft lip and palate).
Main Results:
- A total of 150 OFC patients were studied over two years (2018-2020).
- The prevalence of CHDs among the studied OFC patients was 30.7%.
- No statistically significant association was identified between the type of OFC and the likelihood of having a CHD.
Conclusions:
- A substantial prevalence of CHDs exists in OFC patients, underscoring the need for cardiac screening.
- The specific type of orofacial cleft did not correlate with an increased risk of congenital heart defects.
- Routine cardiac evaluation is advised for all individuals with OFCs to detect potentially serious cardiac anomalies.
Background:
Congenital heart defects (CHDs) are one of the most common associated anomalies in patients with an orofacial cleft (OFC). However, few studies have shown the association between cleft type and CHDs in our population. This study aimed to assess the prevalence of CHDs in a cohort of OFC patients at a tertiary health facility in Nigeria, as well as assess the risk of CHD by OFC type.
Materials And Methods:
This was a prospective study design. Patients with an OFC were consecutively enrolled at a single OFC treatment facility. All subjects were assessed by a paediatric cardiologist and had echocardiography done. They were categorised based on the presence of CHDs, as well as the OFC phenotypic type (cleft lip and/or alveolus, cleft lip and palate and cleft palate only). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was set at P < 0.05.
Results:
A total of 150 subjects enrolled in the study over a period of 2 years (2018-2020). The median age of subjects was 6 months (interquartile range: 2-24), and 54.7% were female. The prevalence of CHDs in the subjects reviewed was 30.7%. Based on the severity of CHDs, the majority presented with simple defects (95.6%). Overall, the most common presentation was patent foramen ovale (12.7%), followed by septal defects (8.0%). There was no significant association between cleft type and the odds of a CHD.
Conclusion:
The study reports a relatively high prevalence of CHDs in patients with OFC; however, there was no association between the risk of CHD by cleft type. Although a majority of CHDs may pose a low operative risk, cardiac evaluation is recommended for all cases of OFC to aid the identification of potentially high-risk cases.
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