Objectives: To evaluate growth patterns in US children with cleft overall and by cleft lip (CL), CL and palate (CLP), and cleft palate (CP) across US children’s hospitals from 0 to 18 mo of age. Design: We conducted a retrospective cohort study leveraging medical records from 2009 to 2022 in children with a cleft seen at 8 US children’s hospitals. Participants: Individuals with a cleft seen at a PEDSnet consortium hospital. Exposure: We examined growth over time, by cleft type, and across hospitals. Main Outcomes: We used electronic health data to generate weight-for-age z scores (WAZ) and length-for-age z scores (LAZ), as well as underweight (WAZ 0.05). All children had a higher prevalence of underweight and stunting relative to World Health Organization growth standards. Underweight and stunting were highest among those with CP, followed by CLP and then CL, and varied across hospitals. Conclusions: Growth trajectories were slower in the first 4 mo of life, followed by rapid catch-up in weight to 12 mo of age. Children with cleft had a high prevalence of underweight and stunting at all ages. Variability across hospitals suggests that care patterns may affect growth. Close growth monitoring in the first 4 mo in children with cleft may be warranted. Knowledge Transfer Statement: US children with a cleft of the lip and/or palate have substantial growth deficits that vary by cleft type, comorbidities, and across hospitals, particularly in the first 4 mo of life.
McKinney et al. (Tue,) studied this question.