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Risk of Fetal Growth Restriction in United States Live Births with Cleft Lip and Palate

Kulkarni, Nina
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573575602411792

Abstract Details

2019, MPH, University of Cincinnati, Medicine: Global Health.
Children with isolated cleft lip and/or palate often have delayed growth during infancy and childhood, which can ultimately lead to long-term health effects. Whether growth abnormalities precede birth in affected infants is not clearly understood. One purpose of this study is to analyze a contemporary cohort of United States (U.S.) live births to measure the association of fetal growth restriction (FGR) and cleft lip and palate while accounting for coexisting risk factors. This study is a population-based retrospective cohort study of U.S. live births (2012-2016). Differences in frequency and risk of FGR, defined as birth weight <10th percentile for gestational age, and severe FGR <5th percentile are calculated for isolated cleft lip, isolated cleft palate, and cleft lip with cleft palate cases and compared to unaffected births using chi square. Multivariate logistic regression was employed to estimate the relative risk of cleft lip and palate on FGR after accounting for the influence of coexisting risk factors. Analyses of cleft lip/palate were limited to cases with no other fetal malformations or genetic abnormalities. Of the 19,844,580 U.S. live births from 2012-2016, 0.05% (n=9,906) had isolated cleft lip, 0.02% (n=4,376) had isolated cleft palate, and 0.003% (n=685) had both cleft lip and palate. Compared to non-anomalous births, the adjusted risk of severe FGR <5th percentile is over 2-fold increased for cleft lip/ palate even after accounting for confounding risk factors, [2.89 (2.19, 3.81)]. The adjusted relative risk is also significantly increased for FGR <10th percentile, but to a lesser degree, [2.27 (1.82, 2.83)]. The highest adjusted relative risks of FGR found in cases with both cleft lip and cleft palate, FGR<5th percentile [2.89 (2.19,3.81)] and FGR<10th [2.27 (1.82, 2.83)]. Medical and pregnancy complications have the strongest confounding risk on FGR in cleft lip/ palate cases compared to other risk factors, but even after adjustment the increased risk of FGR persisted.Isolated cleft lip/ palate is an independent risk factor for FGR even after accounting for coexisting risk factors. The risk is higher for severe FGR, where the risk exceeds a 2-fold increase. These findings support that growth abnormalities in infants with orofacial clefting precedes the influence of oral feeding and begins during fetal development.
Aimin Chen, Ph.D. (Committee Chair)
Emily DeFranco, D.O. M.S. (Committee Member)
Charles Doarn, M.B.A. (Committee Member)
Jun Ying, Ph.D. (Committee Member)
40 p.
Public Health
fetal growth restriction; maternal; cleft palate; FGR; restriction; cleft lip

Recommended Citations

Citations

  • Kulkarni, N. (2019). Risk of Fetal Growth Restriction in United States Live Births with Cleft Lip and Palate [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573575602411792

    APA Style (7th edition)

  • Kulkarni, Nina. Risk of Fetal Growth Restriction in United States Live Births with Cleft Lip and Palate. 2019. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573575602411792.

    MLA Style (8th edition)

  • Kulkarni, Nina. "Risk of Fetal Growth Restriction in United States Live Births with Cleft Lip and Palate." Master's thesis, University of Cincinnati, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573575602411792

    Chicago Manual of Style (17th edition)

ucin1573575602411792
334
© 2019, some rights reserved.Creative Commons License Risk of Fetal Growth Restriction in United States Live Births with Cleft Lip and Palate by Nina Kulkarni is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by University of Cincinnati and OhioLINK.