Birth Weight, Body Length, and Cranial Circumference in Newborns with Cleft Lip or Palate

1998 ◽  
Vol 35 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Magnus Becker ◽  
Henry Svensson ◽  
Bengt Källén
Keyword(s):  
Birth Weight ◽  
Body Length ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Statistical Significance ◽  
The Body ◽  
Control Subjects ◽  
Study Population ◽  
Isolated Cleft Palate ◽  
Pierre Robin

Objective This paper reports on birth weight, body length, body mass index, and cranial circumference at birth of infants with cleft lip and/or palate born between 1973 and 1992. Methods Data were obtained from two nationwide swedish health registries. Infants with syndromes, twins, and infants with immigrant parentage were excluded from the study. Comparisons were made with all singleton births with the same exclusion criteria (n = 2,031,140). Results The body dimensions of infants with isolated cleft lip (n = 865) were found not to differ from those of control subjects, but infants with isolated cleft palate (n = 811) or cleft lip and palate (n = 1139) were found to be lighter and shorter than control subjects. Also, infants with the Pierre Robin sequence (n = 121) had a tendency to be lighter and shorter than control subjects, but these differences did not reach statistical significance despite the large study population.

Incidence of Cleft Lip and Palate and Risks of Additional Malformations

1998 ◽  
Vol 35 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Catharina Hagberg ◽  
Ola Larson ◽  
Josef Milerad
Keyword(s):  
Birth Weight ◽  
Birth Defects ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Live Births ◽  
Different Types ◽  
Mother’S Age ◽  
Rate Ratios ◽  
Isolated Cleft Palate ◽  
Similar Incidence

Objective and Methods Children with cleft lip and/or palate (n = 251) born between 1991 and 1995 in the county of Stockholm, Sweden, were studied with reference to incidence and rate ratios (RRs) of different types of clefts, gender, birth weight, mother's age, and length of pregnancy. Children who had clefts and additional malformations were compared with children who had clefts but no additional malformations. Results The incidence of clefts was 2.0/1000 live births, and it was higher among males than among females. The RR, an index of relative risk, was 1.58. The main groups, children with isolated cleft lip, children with cleft lip and palate, and children with isolated cleft palate, showed similar incidence values (0.6-0.7/1000 live births). Children with bilateral clefts had an incidence of 0.3/1000 live births. Additional malformations were found in approximately every sixth newborn with a cleft when children with Robin sequence were excluded. There was a tendency for newborns with bilateral clefts to have additional malformations (RR = 1.36; confidence interval = 0.74-2.49). Children with clefts and additional malformations had lower birth weight and were born earlier than children with clefts only. Conclusion Preterm cleft children with low birth weight should be screened for the presence of other birth defects.

scholarly journals Use of a Simple Anthropometric Measurement to Identify Low-Birth-Weight Infants in Enugu, Nigeria

2018 ◽  
Vol 5 ◽  
pp. 2333794X1878817
Author(s):  
Ndubuisi Kennedy Chukwudi ◽  
Huldah Ijeoma Nwokeukwu ◽  
Gilbert Nwadiakanma Adimorah
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Linear Regression Analysis ◽  
Cutoff Point ◽  
Chest Circumference ◽  
Anthropometric Measurement ◽  
Suitable Alternative ◽  
Study Population

Background. This prospective study was conducted to identify a suitable alternative to birth weight and establish its cutoff point to facilitate the identification of low-birth-weight (LBW) infants in Enugu, Southeast Nigeria. Methods. The study involved newborn babies within the first 48 hours of life. Five anthropometric measurements (head, chest, mid-arm and calf circumferences, as well as abdominal girth) were taken using a tape measure while supine length was measured with an aluminum infantometer. Birth weight was also recorded. Linear regression analysis was done to identify the measurement with the highest coefficient of determination with birth weight while its cutoff point was defined using a receiver operating characteristic curve. Standard statistical tests were used to determine the statistical significance of the findings. Results. The LBW prevalence for the study population was 21.41%. Chest circumference had the highest R2 value of 0.83 for the general study population and 0.72 for the LBW infants. The identified cutoff point for chest circumference is ⩽30 cm. Conclusion. Chest circumference is the best alternative to birth weight in identifying LBW babies within the first 48 hours of life in this environment.

Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

1995 ◽  
Vol 32 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Yasuo Honda ◽  
Akira Suzuki ◽  
Masamichi Ohishi ◽  
Hideo Tashiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Displacement ◽  
Growth Patterns ◽  
Posterior Displacement ◽  
Arch Width ◽  
Dental Hospital ◽  
Growth Changes ◽  
Isolated Cleft Palate ◽  
Maxillary Arch

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

The aetiology and pathogenesis of craniofacial deformity

Development ◽  
1988 ◽  
Vol 103 (Supplement) ◽  
pp. 207-212
Author(s):  
David Poswillo
Keyword(s):  
Neural Crest ◽  
Animal Studies ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treacher Collins Syndrome ◽  
Apert Syndrome ◽  
Craniofacial Malformations ◽  
Craniofacial Microsomia ◽  
Animal System ◽  
Isolated Cleft Palate

Craniofacial malformations have been recorded since time immemorial. While observational studies have assisted in the recognition of syndromes, little light has been shed on the causal mechanisms which interfere with craniofacial development. Animal studies in which malformations occur spontaneously or have been induced by teratogenic agents have permitted step-by-step investigation of such common deformities as cleft lip and palate. The role of the ectomesenchymal cells of the neural crest and the possible phenomenon of disorganized spontaneous cell death are described in relation to lip clefts. The factors associated with isolated cleft palate, Pierre Robin syndrome and submucous clefts are described by reference to animal models. The haemorrhagic accident preceding the onset of craniofacial microsomia is discussed as is the distinctly different phenomenon of disturbance to the migration or differentiation of neural crest cells in the pathogenesis of Treacher Collins syndrome. The more severe anomalies of the calvarium such as plagiocephaly, Crouzon and Apert syndrome still defy explanation, in the absence of an appropriate animal system to study; some thoughts on the likely mechanism of abnormal sutural fusions are discussed.

Initial Nutritional Assessment of Infants with Cleft Lip and/or Palate: Interventions and Return to Birth Weight

2017 ◽  
Vol 54 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Alison Kaye ◽  
Kristi Thaete ◽  
Audrey Snell ◽  
Connie Chesser ◽  
Claudia Goldak ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nutritional Assessment ◽  
Initial Assessment ◽  
Average Birth Weight ◽  
Nutritional Interventions

Objective To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design Retrospective review. Setting Tertiary pediatric hospital. Patients One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012. Main Outcome Measures Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments. Results All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP. Conclusions Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

A Comparison of Three Methods of Repairing the Hard Palate

2002 ◽  
Vol 39 (4) ◽  
pp. 383-391 ◽  
Author(s):  
R. W. Pigott ◽  
E. H. Albery ◽  
I. S. Hathorn ◽  
N. E. Atack ◽  
A. Williams ◽  
...  
Keyword(s):  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Small Sample ◽  
Velopharyngeal Insufficiency ◽  
Strong Trend ◽  
Computer Based ◽  
Palate Repair

Objective To compare growth, speech, and nasal symmetry outcomes of three methods of hard palate repair. Patients Consecutive available records of children born with unilateral bony complete cleft lip and palate over the period 1972 to 1992. Interventions Identical management of lip, nose, alveolus, and soft palate. Hard palate repair by Cuthbert Veau (CV) from 1972 to 1981, von Langenbeck (vL) from 1982 to 1989, or medial Langenbeck (ML) from 1989 to 1991. Outcome Measures For growth: GOSLON yardstick or 5-year model index. For speech: articulation test. Nasal anemometry. For nasal symmetry: Coghlan computer-based assessment. All these measures were developed during the period of data collection but not for this project. Results There was a strong trend toward more favorable anteroposterior maxillary growth with the change from CV to vL to ML techniques. This fell short of statistical significance because of the small sample size. There was a significant reduction in cleft-related articulation faults (p = .01) considered to be related to improved arch form. In the absence of improved rates of velopharyngeal insufficiency or nasal symmetry, increased surgical experience was discounted as a significant contribution to improved growth and articulation outcomes. Conclusions Reduced periosteal undermining and residual exposed palatal shelf from CV to vL to ML improved incisor relationships and articulation.

Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion With Severe Maxillary Deficiency in Isolated Cleft Palate

2018 ◽  
Vol 56 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Kohei Nakatsugawa ◽  
Hiroshi Kurosaka ◽  
Kiyomi Mihara ◽  
Susumu Tanaka ◽  
Tomonao Aikawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Surgical Approach ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Rapid Palatal Expansion ◽  
Isolated Cleft Palate ◽  
Maxillary Deficiency

Orthodontic treatment in patients with orofacial cleft such as cleft lip and palate or isolated cleft palate is challenging, especially when the patients exhibit severe maxillary growth retardation. To correct this deficiency, maxillary expansion and protraction can be performed in the first phase of orthodontic treatment. However, in some cases, the malocclusion cannot be corrected by these procedures, and thus, skeletal discrepancy remains when the patients are adolescents. These remaining problems occasionally require various orthognathic treatments according to the degree of the discrepancy. Here, we describe one case of a female with isolated cleft palate and hand malformation who exhibited severe maxillary deficiency until her adolescence and was treated with multiple orthognathic surgeries, including surgically assisted maxillary expansion (surgically assisted rapid palatal expansion), LeFort I osteotomy, and bilateral sagittal split osteotomy in order to correct severe skeletal discrepancy and malocclusion. The treatment resulted in balanced facial appearance and mutually protected occlusion with good stability. The purpose of this case report is to show the orthodontic treatment outcome of 1 patient who exhibited isolated cleft palate and subsequent severe skeletal deformities and malocclusion which was treated by an orthodontic-surgical approach.

Pattern of Cleft Lip and Palate in Hospital-Based Population in Saudi Arabia: Retrospective Study

2008 ◽  
Vol 45 (6) ◽  
pp. 592-596 ◽  
Author(s):  
Aziza Aljohar ◽  
Kandasamy Ravichandran ◽  
Shazia Subhani
Keyword(s):  
Saudi Arabia ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Positive Family History ◽  
Care Hospital ◽  
Associated Anomalies ◽  
Cleft Lip Palate ◽  
Isolated Cleft Palate

Objective: To report the patterns of cleft lip and/or cleft palate in Saudi Arabia from data collected at a tertiary care hospital. Design and Setting: King Faisal Specialist Hospital and Research Center, Riyadh. Patients: All the cleft lip and/or cleft palate patients registered in the Cleft Lip/Palate and Craniofacial Anomalies Registry from June 1999 to December 2005. Results: Retrospectively, 807 cases of cleft lip and/or palate were registered. There were 451 boys and 356 girls. Cleft lip and palate was more common (387) than isolated cleft palate (294) and isolated cleft lip (122). Boys predominated in cleft lip and palate and cleft lip; whereas, girls predominated in isolated cleft palate, with boy to girl ratios of 1.6:1, 1.2:1, and 0.9:1 for cleft lip and/or palate, isolated cleft lip, and isolated cleft palate, respectively. The Riyadh region had more cases (32.0%) than the Asir (15.6%) and Eastern (14.6%) regions. Parents of 439 individuals had consanguineous marriages. A positive family history of cleft was seen in 224 cases. Of 238 cases with associated anomalies, 91 had congenital heart disease. Of the children with isolated cleft palate, 40.5% had associated anomalies, whereas only 23.0% of the children with isolated cleft lip or cleft lip and palate had associated malformations. Conclusion: The pattern of cleft observed in this study does not differ significantly from those reported in the literature for Arab populations.

No Evidence for Linkage and Association between 4q Microsatellite Markers and Nonsyndromic Cleft Lip and Palate in Chilean Case-Parents Trios

2005 ◽  
Vol 42 (3) ◽  
pp. 267-271 ◽  
Author(s):  
Rafael Blanco ◽  
José Suazo ◽  
JoséLuis Santos ◽  
Hernán Carreño ◽  
Hernán Palomino ◽  
...  
Keyword(s):  
Linkage Disequilibrium ◽  
Microsatellite Markers ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Association Studies ◽  
Statistical Significance ◽  
P Value ◽  
Genetic Trait ◽  
Multiple Alleles ◽  
Cleft Lip Palate

Objective Nonsyndromic cleft lip/palate (NSCLP) has the characteristics of a complex genetic trait. Linkage and association studies have suggested that one or more clefting loci may be located on chromosome 4q. The goal of this study was to evaluate the possible linkage and association due to linkage disequilibrium between five microsatellite markers located on 4q28 to 4q33 and NSCLP, using the case-parent trio design. Subjects and Methods A total of 56 Chilean families (32 simplex and 24 multiplex) were recruited. Microsatellite markers were analyzed using polymerase chain reaction with fluorescent-labeled forward primers, followed by electrophoresis on a laser-fluorescent sequencer. Case-parents trios were ascertained to assess linkage and linkage disequilibrium through a multistage procedure. Transmission disequilibrium tests for multiple alleles were carried out to assess the statistical significance of 4q28 to 4q33 microsatellite markers. Results Only weak evidence for linkage was obtained for the FGA marker (asymptotic uncorrected p value = .08 and empirical p value = .05). Only the FGA and UCP1 markers were selected for association analysis in trios, with unrelated cases achieving a nearly significant result for the UCP1 marker (asymptotic uncorrected p value = .07 and empirical p value = .19). Conclusion Though the FGA and UCP1 markers showed nearly significant p values for linkage and association, respectively, the results of the present study provided insufficient evidence of the existence of a major susceptibility locus in the 4q region that was analyzed in the present study.

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