Related Experiment Video
Updated: Jun 25, 2025
Quantification of Orofacial Phenotypes in Xenopus
Published on: November 6, 2014
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.
Insights
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.
Background:
Little is known about how young children with orofacial cleft grow over time.
Objective:
To characterize longitudinal growth patterns from ages 0 to 36 months in US children with an orofacial cleft.
Design:
A retrospective cohort study.
Participants/Setting:
Children with cleft lip, cleft lip and palate, or cleft palate who were younger than age 36 months at a hospital encounter between 2010 and 2019 (N = 1334) were included. The setting was a US tertiary care children's hospital with a cleft center that serves a 5-state region.
Main Outcome Measure:
Weight-for-age z scores (WAZ) and length-for-age z scores (LAZ).
Statistical Analyses Performed:
Longitudinal growth patterns were characterized using generalized linear mixed models to estimate mean WAZ and LAZ from age 0 to 36 months.
Results:
Growth in infants with cleft slowed dramatically during the first 3 to 4 months of life, rebounded with catch-up growth until age 12 months for cleft lip and cleft palate and until age 36 months for cleft lip and palate. When comparing populations, children with any type of cleft demonstrated subpar growth compared with World Health Organization standards. Growth deficits were more common in those with cleft lip and palate and cleft palate compared with those with cleft lip. The intraclass coefficient showed that most of the variability in the WAZ (65%) was between individuals, whereas 35% was within an individual. The intraclass coefficient for LAZ showed that most of the variability in the LAZ (74%) was between individuals, whereas 26% was within an individual. The proportion of variance attributable to cleft type and/or comorbidities accounted for <5% of the variance for WAZ and LAZ. WAZ and LAZ were lower in children with comorbidities than those without comorbidities with cleft and World Health Organization standards.
Conclusions:
Infants with cleft lip and palate, cleft palate, and a cleft with comorbidities have higher rates of poor growth than peers with cleft lip and a cleft with no comorbidities, respectively.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:15Teeth
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin...
01:16Psychosexual Stages of Personality: Oral
Weaning, typically occurring...