Birth Weight in Infants with a Cleft Lip and/or Palate: A Systematic Review and Meta-Analysis

To understand the association between birth weight and orofacial cleft (cleft) considering key covariates.

We conducted a systematic review and meta-analysis by searching 7 electronic databases for articles published before February 9, 2025. We used Rayyan systematic review software to screen 5651 identified articles with birth weight estimates on infants with cleft. Two reviewers manually reviewed 296 articles for eligibility; a third reviewer resolved any discrepancies. We extracted data on birth weight (mean and low birth weight [<2500 g]), cleft type (cleft lip, cleft palate, cleft lip, and palate), comorbidity status (yes/no), and country income status (high vs low- or middle-income per World Bank). We used a multilevel mixed-effects model to estimate overall birth weight and birth weight stratified by cleft type, comorbidity status, and country income status.

Sixty-three studies were included; 39 studies (66 effect sizes, n = 25 991 infants) reported mean birth weight in infants with cleft. Unadjusted mean birth weight was 3143g (95% CI: 3056, 3231). Mean birth weight was 3405g (95% CI: 3285, 3525) after adjusting for cleft type, comorbidity status, and country income status. Lower birth weight estimates were observed among infants in low- or middle-income (vs high-income) country status and for infants with comorbidities (vs no comorbidities).

Birth weight in infants with cleft is similar to global birth weight standards after accounting for country income status and comorbidity status and adjusted birth weight did not differ by cleft type. These findings emphasize the need for close attention to postnatal growth monitoring, feeding, and nutritional interventions among infants with cleft.