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Cleft lip Sidedness and the Association with Additional Congenital Malformations

Matthew Fell1,2, Kate J Fitzsimons3, Mark J Hamilton4

  • 1Spires Cleft Centre, John Radcliffe Hospital, Oxford, UK.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|June 13, 2024
PubMed

Insights

The prevalence of additional congenital malformations in cleft lip +/- alveolus (CL +/- A) cases did not differ by cleft side. However, right-sided and bilateral cleft lip and palate (CLP) cases showed higher rates of additional anomalies compared to left-sided CLP.

Area of Science:

  • Medical research
  • Genetics
  • Pediatrics

Background:

  • Orofacial clefts are common birth defects.
  • The sidedness of clefts (left, right, or bilateral) may be associated with other congenital anomalies.
  • Understanding these associations can provide insights into underlying etiologies.

Purpose of the Study:

  • To investigate the association between the sidedness of orofacial clefts and the occurrence of additional congenital malformations.
  • To compare the prevalence of associated anomalies across left, right, and bilateral cleft lip +/- alveolus (CL +/- A) and cleft lip and palate (CLP) phenotypes.

Main Methods:

  • Utilized linkage of a national cleft birth registry with national hospital admission data in England.
  • Analyzed data from 2007 children with CL +/- A and 2724 children with CLP born between 2000 and 2012.
  • Determined the proportion of children with ICD-10 codes for additional congenital malformations based on cleft sidedness.

Main Results:

  • For CL +/- A, no significant difference in additional malformation prevalence was found between left (22%), right (22%), and bilateral (23%) clefts.
  • For CLP, left-sided clefts (23%) had a lower prevalence of additional malformations compared to right-sided (32%) and bilateral (33%) clefts.
  • Statistical analysis showed significant differences for CLP (P < .001 for both right and bilateral vs. left).

Conclusions:

  • The prevalence of additional congenital malformations varied by sidedness within CLP cases but not within CL +/- A cases.
  • Findings suggest distinct underlying etiologies for CL +/- A and CLP.
  • The etiology of right-sided CLP may be more similar to bilateral CLP than to left-sided CLP.

Keywords:
cleft lipcleft lip and palateepidemiologyetiology

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