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Growth Patterns Between Ages 0 and 36 Months Among US Children With Orofacial Cleft: A Retrospective Cohort Study
Christy M McKinney1, Waylon Howard2, Kiley Bijlani2
1Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington; University of Washington, Seattle, Washington.
Journal of the Academy of Nutrition and Dietetics
|May 27, 2024
Summary
Children with orofacial clefts experience slowed growth, especially in the first months. Catch-up growth occurs, but overall growth remains below standards, with specific cleft types and comorbidities impacting outcomes.
Area of Science:
- Pediatric Growth and Development
- Craniofacial Anomalies
- Public Health
Background:
- Longitudinal growth patterns in young children with orofacial clefts are not well understood.
- Orofacial clefts can impact feeding, nutrition, and overall development.
Purpose of the Study:
- To characterize the longitudinal growth patterns of US children with orofacial clefts from birth to 36 months.
- To identify factors influencing growth trajectories in this population.
Main Methods:
- Retrospective cohort study of 1334 children with cleft lip, cleft lip and palate, or cleft palate.
- Analysis of weight-for-age z scores (WAZ) and length-for-age z scores (LAZ) using generalized linear mixed models.
- Inclusion of children younger than 36 months at a tertiary care children's hospital.
Main Results:
- Infant growth slowed significantly in the first 3-4 months, followed by catch-up growth up to 12 or 36 months depending on cleft type.
- Children with any cleft type showed subpar growth compared to World Health Organization standards.
- Growth deficits were more pronounced in children with cleft lip and palate and cleft palate compared to cleft lip alone.
- Comorbidities were associated with lower WAZ and LAZ.
Conclusions:
- Infants with cleft lip and palate, cleft palate, and comorbidities exhibit higher rates of poor growth.
- Cleft lip alone is associated with better growth outcomes compared to other cleft types.
- Individual variability significantly influences growth, with cleft type and comorbidities accounting for a small proportion of this variance.
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