Do Orofacial Clefts Impair Breastfeeding and Increase the Prevalence of Anemia?

2021 ◽  
pp. 105566562110543
Author(s):  
Aluísio Eustáquio de Freitas Miranda-Filho ◽  
Heloisa de Sousa Gomes ◽  
Roberta Bessa Veloso Silva ◽  
Nelson Pereira Marques ◽  
Hercílio Martelli ◽  
...  

Objective This study aimed to correlate the prevalence of iron deficiency anemia and breastfeeding with orofacial clefts in children. Design Data on the participant profile, presence and type of the cleft lip and/or palate (CL/P), and records on anemia and breastfeeding were collected from patients’ charts, and submitted to statistical analysis by χ2 test ( p < .05; software SPSS 23.0). Results Two-hundred and ten files were divided according to: CL/P presence (cleft group;    n = 132) or absence (control group;    n = 78). Group CL/P was subdivided according to the type of cleft: CL/P-I (cleft lip;    n = 35); CL/P-II (cleft lip and palate;    n = 45); CL/P-III (cleft palate;    n = 43); and CL/P-IV (rare orofacial clefts;    n = 9). Group CL/P had significantly more records on anemia ( p = .016) and fewer records on breastfeeding (P<.01) than controls. More records on anemia occurred in CL/P-II ( p = .004) and CL/P-IV ( p = .006) than the control group. The comparison among the orofacial cleft types regarding the anemia records showed no statistically significant differences ( p = .123). Group CL/P-I had more records on breastfeeding than the other cleft types ( p < .01). Conclusions Thus, it is suggested that the breastfeeding process is more complex, and the history of anemia is more frequent, in children with cleft lip and palate or rare orofacial clefts than in children without clefts.

2016 ◽  
Vol 83 (3) ◽  
pp. 265-268 ◽  
Author(s):  
Adrianna Mostowska ◽  
Kamil K. Hozyasz ◽  
Piotr Wójcicki ◽  
Barbara Biedziak ◽  
Joanna Wesoły ◽  
...  

The project “Searching for new genes and loci involved in cleft lip and palate in the Polish population – genome-wide association study” is a case-control study in a group of unrelated subjects with non-syndromic cleft lip with or without cleft palate (NSCL/P) and healthy individuals with no family history of clefting or other congenital disorders. The overall goal of this grant proposal is to identify novel genetic factors, which can play a significant role in the pathogenesis of orofacial clefts in the Polish population. To accomplish the proposed aim, a two stage genome-wide association study will be performed. In the first stage, Illumina's HumanOmni Express BeadChips arrays will be used to genotype over 700,000 polymorphisms in NSCL/P patients and controls. In the second stage, SNPs showing the most compelling association with the risk of orofacial clefts will be tested in an independent sample set using standard genotyping methods. This research project is expected to be completed in July 2015.


2017 ◽  
Vol 54 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Elizabeth J. Leslie ◽  
Jenna C. Carlson ◽  
Margaret E. Cooper ◽  
Kaare Christensen ◽  
Seth M. Weinberg ◽  
...  

Objective Monozygotic twins of an individual with an orofacial cleft have a significantly elevated risk for orofacial cleft compared with the general population, but still the concordance rate for orofacial cleft in monozygotic twins is about 40% to 50%. The goal of this study was to determine whether unaffected cotwins have an increased frequency of orbicularis oris muscle defects, a subclinical form of orofacial cleft. The presence of such defects may reduce the overall rate of discordance. Method A total of 63 discordant monozygotic and dizygotic twin pairs, 262 unaffected nontwin siblings, and 543 controls with no history of orofacial clefts were assessed for orbicularis oris defects by high-resolution ultrasound. Frequencies were compared by the Fisher exact test. Results Unaffected cotwins from discordant monozygotic pairs had a higher frequency of defects (12.5%) than the other test groups (6.38% to 6.99%), but the difference was not statistically significant ( P = .74). Conclusions In this study, orbicularis oris defects were not statistically significantly more common among the unaffected twins from orofacial cleft discordant twin pairs. The trends in the results warrant future studies with larger sample sizes and additional subclinical phenotypes.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
P. Agbenorku ◽  
M. Yore ◽  
K. A. Danso ◽  
C. Turpin

Background. Cleft lip and cleft palate are among the most common orofacial congenital anomalies. This study is to establish Orofacial Clefts Database for Kumasi, Ghana, with a view to extend it to other cities in future to obtain a national orofacial anomaly database. Methods. A descriptive prospective survey was carried out at eleven selected health facilities in Kumasi. Results. The total number of live births recorded was 27,449. Orofacial anomalies recorded were 36, giving an incidence of 1.31/1000 live births or 1 in 763 live births. The mean maternal age of cleft lip/palate babies was 29.85 years (range 18–40 years). The male : female ratio for the orofacial anomalies babies was 1.3 : 1; the male : female ratio was 0.5 : 1 in the cleft lip group, 1.3 : 1 in the cleft lip and palate group, and 4 : 1 in the cleft palate group. The majority of clefts were unilateral (69.4%, n=25), with females (n=14) outnumbering males (n=11). A family history of cleft was recorded with five babies (13.9%). Associated congenital anomalies were recorded in seven (19.4%) cleft lips and/or palates. Conclusion. The incidence of 1 in 763 live births found in this study indicates that cleft lip/palate is a common congenital anomaly in Kumasi.


2020 ◽  
pp. 105566562098063
Author(s):  
Sima Dabbaghi Galeh ◽  
Masoud Nouri-Vaskeh ◽  
Mahdieh Alipour ◽  
Shahin Abdollahi Fakhim

Objective: Orofacial clefts (OFCs) can occur as an isolated defect or as a manifestation of other syndromes. The current study aimed to evaluate demographic characteristics and distribution of different types of accompanying anomalies for OFCs in the northwest of Iran. Design: A retrospective cohort study. Setting: Tertiary pediatric hospital. Patients and Participants: This study was conducted on 1500 cleft lip and/or palate patients born between July 2010 and June 2020 in the northwest of Iran. Main Outcome Measures: Demographic and clinical characteristics of the children with OFCs including familial history, accompanying anomalies and syndromes, maternal passive smoking, mothers’ and fathers’ age, consanguineous marriage, and birth order. Results: Among 1500 patients, 441 had cleft lip, 615 had cleft palate, and 444 had cleft lip and palate. The positive family history of OFCs was found to be 20.9% to 25.4% depending on the cleft type. Accompanying anomalies were identified in 29.8% of cases. Cardiac, facial, and ear abnormalities were the most common types. Also, 2.9% were identified with syndromes and sequences. These included Pierre Robin Sequence, Velo-cardio-facial syndrome, and Down syndrome most frequently. Conclusion: These findings may provide references for appropriate resources to establish and direct counseling and primary preventive projects in the northwest of Iran.


2020 ◽  
pp. 105566562096957
Author(s):  
Ikenna Gerald Isiekwe ◽  
Taofeek Olalekan Ligali ◽  
Mohammed Adam Sheikh Abdullahi ◽  
Wasiu Lanre Adeyemo

Background and Aim: Children with cleft lip and palate present with a wide range of dental and occlusal anomalies as a result of the cleft defect. These patients also present with oral habits which may affect their quality of life. The aim of this study was to compare the prevalence of oral habits in these children, with children without orofacial clefts. Methodology: This was a cross-sectional comparative study comparing children with repaired cleft lip and/or palate aged 3 to 12 years, with children without orofacial clefts. Ethical approval for the study was obtained from the institutional review boards of both centers. Data collection was via interviewer administered questionnaires given to the parents/guardians of the children in each group. Data analysis was carried out using SPSS version 23. The level of significance was set at P < .05. Results: A total of 107 respondents participated in the study, comprising 53 children with repaired cleft lip and/or palate 54 children without orofacial clefts. The mean age for the children with Cleft lip and/or palate/ was 6.81 (standard deviation [SD] 1.898) years, while that for the control group was 7.78 (SD 1.68) years. Two oral habits recorded a significantly higher prevalence ( P < .05) in the children with repaired clefts as compared to controls and these were lip sucking and bruxism. No significant difference in prevalence was recorded for all the other oral habits surveyed. Conclusion: A significantly higher prevalence ( P < .05) was observed in lip sucking and bruxism among children with cleft lip and palate, as compared to the children without orofacial clefts.


2000 ◽  
Vol 37 (3) ◽  
pp. 303-317 ◽  
Author(s):  
N.V. Hermann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
S. Bolund ◽  
S. Kreiborg

Objective The objective of the study was to analyze the craniofacial morphology in infants with unilateral complete cleft lip and palate (UCCLP) in which the lip and the anterior part of the palate had been surgically closed at 2 months of age and to compare the morphology with that of a control group with unilateral incomplete cleft lip (UICL) in which the lip had also been surgically closed at 2 months of age. Design The sample consisted of a total of 108 cleft children all fulfilling the entry criteria, besides diagnosis, as follows: The child was of Danish origin; the age of the child was between 650 and 750 days (approximately 22 months) at the time of examination; the child was healthy except for its single cleft malformation; the surgical procedure in each group had been performed at about 2 months of age by the same surgeon. The surgical methods used were a Tennison procedure (UICL group) and a Tennison procedure supplemented by palatovomer plasty (UCCLP group). Methods The method of investigation was infant cephalometry in the lateral, frontal, and axial projections. Linear, angular, and area variables describing the craniofacial morphology were calculated and supplemented by mean plots from the cephalometric projections in the two groups. Results and Conclusions Statistical analysis based on Student's t test showed that the facial morphology in the 22-month-old UCCLP group differed significantly from that of the UICL group. The most pronounced differences were found in the maxillary complex and the mandible. The deviations observed in the UCCLP group at 22 months of age were similar to those previously observed at 2 months of age. However, several of the dysmorphic traits had become less pronounced; some had remained the same; and a few had become worse with time.


2010 ◽  
Vol 47 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Arezoo Jahanbin ◽  
Naser Mahdavishahri ◽  
Mohammad Mahdi Naseri ◽  
Yasaman Sardari ◽  
Sareh Rezaian

Objectives To test the hypothesis that unaffected parents with nonsyndromic bilateral cleft lip and palate children possess greater levels of dermatoglyphic asymmetry than the normal population and to test for the difference in the distribution of pattern types. Design Case-control study. Setting Mashhad University of Medical Sciences, Mashhad, Iran. Participants Forty-five unaffected parents (45 men and 45 women) of children with nonfamilial bilateral cleft lip and palate anomaly were enlisted. A control group of 45 unaffected parents with at least two unaffected children and no prior family history of clefting were also simultaneously selected. Main Outcome Measures Palm prints and fingerprints were taken from each participant, and total ridge counts, atd angles, and pattern types were determined. For each of the three dermatoglyphic measures, asymmetry scores between right and left hands were defined, and then asymmetry scores of unaffected parents and pattern types were compared statistically with the controls, using Mann-Whitney and chi-square tests. Results In contrast to total ridge count asymmetry, the asymmetry of atd angles in unaffected parents and the asymmetry of patterns (in unaffected mothers) were significantly higher in comparison with the controls. Furthermore, unaffected fathers had significantly more arches than the controls, but there were no significant differences in dermatoglyphic patterns of unaffected mothers and the controls. Conclusion The findings suggest that an increase in the asymmetry of atd angles and pattern types in parents of sporadically affected children may reflect more the genetic base of this congenital malformation.


2021 ◽  
Vol 8 (1) ◽  
pp. 38-46
Author(s):  
Kristaninta Bangun ◽  
Chaula Luthfia Sukasah ◽  
Jenisa Amanda Sandiarini Kamayana ◽  
Adi Basuki ◽  
Jessica Halim ◽  
...  

Introduction: As a major facial aesthetic unit, the nose is one of the significant features in cleft lip and palate repair. The use of a naso-alveolar molding (NAM) device was known to help narrow the cleft gap and improve nasal aesthetics. This study aims to evaluate post-operative nasal morphology in unilateral cleft lip and palate patients who had used presurgical NAM, particularly in an established craniofacial centre in one of developing countries. Methods: A cohort retrospective study was conducted at Cleft Craniofacial Centre, Cipto Mangunkusumo Hospital Indonesia, comparing the nasal symmetry in unilateral cleft lip patients with and without prior application of NAM (NAM and control group), twelve months following primary cheiloplasty. Differences between the cleft and normal side were assessed using standard basilar view photographs based on five points nasal measurements. Results: A total of twelve patients were enrolled, six with a history of NAM application and six without (control). Overall nasal measurements confirmed a lower mean of differences in the NAM group compared to the control, showing statistically significant results in nostril height, nasal dome height, and columellar height (p <0.05). Conclusion: This study provides an insight that cleft lip patients with a history of NAM application had superior nasal symmetry compared to patients without presurgical NAM application 1-year post-cheiloplasty. Presurgical NAM application is recommended for patients with unilateral cleft lip and palate.


2017 ◽  
Vol 4 (4) ◽  
pp. 1274
Author(s):  
R. Priyadharshini ◽  
Saji James ◽  
Jebaraj Rathinasamy ◽  
Mahalakshmi R. ◽  
Gautham Gopalakrishnan ◽  
...  

Background: Orofacial cleft is one of the most common congenital facial abnormalities. Congenital heart disease (CHD) has been reported in up to 15% of the patients with orofacial clefts. Clinical cardiac examinations may sometime miss cardiac anomalies in children with orofacial clefts. The aim of our study is to find out CHD by echocardiography and to correlate this with clinical examination findings in children with orofacial clefts.Methods: In this cross-sectional study, 510 patients with orofacial clefts aged 1 month to 18 years were enrolled. History and clinical examination were performed and data entered in a pre-validated proforma. The type of orofacial cleft and syndromic features was specifically noted. Echocardiography was performed for all patients by a paediatric cardiologist and the clinical cardiovascular findings were correlated with the echocardiogram.Results: The commonest deformity was cleft lip and palate (69%), followed by isolated cleft palate (20.4%), and isolated cleft lip (10.6%). In our study population, 87.5% were non-syndromic and 12.5% were syndromic; 21.9% had cardiac anomaly, of which in 7.8% no cardiac defect was detected during systemic cardiovascular examination but their echocardiogram showed cardiac abnormality. This was statistically significant (p<0.000). Atrial Septal Defect was the commonest anomaly in both the groups. Pierre Robin Syndrome was found to be the commonest syndrome.Conclusions: The high prevalence of CHD among children with orofacial clefts in this study justifies the need for screening echocardiography because many times cardiac anomalies might not be detected in routine systemic examination. 


Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1075
Author(s):  
Mārtiņš Vaivads ◽  
Ilze Akota ◽  
Māra Pilmane

Background and Objectives: Cleft lip with or without cleft palate is one of the most common types of congenital malformations. Transcription factors paired box 7 and 9 (PAX7, PAX9) and receptor-like tyrosine kinase (RYK) have been previously associated with the formation of orofacial clefts but their exact possible involvement and interactions in the tissue of specific cleft types remains uncertain. There is a limited number of morphological studies analyzing these specific factors in cleft affected tissue due to ethical aspects and the limited amount of available tissue material. This study analyses the presence of PAX7, PAX9, and RYK immunopositive structures within different cleft affected tissue to assess their possible involvement in cleft morphopathogenesis. Materials and Methods: Cleft affected tissue was collected from non-syndromic orofacial cleft patients during cleft correcting surgery (36 patients with unilateral cleft lip, 13 patients with bilateral cleft lip, 26 patients with isolated cleft palate). Control group oral cavity tissue was obtained from 7 patients without cleft lip and palate. To evaluate the number of immunopositive structures in the cleft affected tissue and the control group, a semiquantitative counting method was used. Non-parametric statistical methods (Kruskal–Wallis H test, Mann–Whitney U test, and Spearman’s rank correlation) were used. Results: Statistically significant differences for the number of PAX7, PAX9, and RYK-positive cells were notified between the controls and the patient groups. Multiple statistically significant correlations between the factors were found in each cleft affected tissue group. Conclusions: PAX7, PAX9, and RYK have a variable involvement and interaction in postnatal morphopathogenesis of orofacial clefts. PAX7 is more associated with the formation of unilateral cleft lip, while PAX9 relates more towards the isolated cleft palate. The stable presence of RYK in all cleft types indicates its possible participation in different facial cleft formations.


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