Factors Influencing Nasoalveolar Molding Treatment Completion and Noncompletion in Infants with Cleft Lip and Palate.

Abstract

ObjectiveIdentify sociodemographic factors and comorbidities predictive of nasoalveolar molding (NAM) treatment completion and noncompletion in infants with cleft lip with or without (+/-) cleft palate in a rural-suburban population.DesignRetrospective cohort study.SettingTertiary medical center.Patients, ParticipantsInfants diagnosed with cleft lip +/- cleft palate who initiated NAM treatment between 2013 and 2023. Forty-seven patients met inclusion criteria.Main Outcome Measure(s)Prevalence of NAM treatment completion, defined as continued attendance of NAM appointments until initial lip repair surgery.ResultsNAM treatment noncompletion rate of 23.4%. Noncomplete NAM treatment was associated with greater additional unscheduled NAM visits (P < .001); increased days inpatient after birth (P < .001); NICU admission (P < .001); public insurance (P = .007); preterm birth (P = .008); history of social work visits (P = .024); increased comorbidities (P = .028); non-Caucasian race (P = .034); and presence of siblings (P = .036). Associated comorbidities included use of feeding tube (P < .001); and conditions related with renal (P < .001); cardiac (P = .004); failure to thrive (P = .009); syndromes (P = .009); orthopedic (P = .011); pulmonary (P = .022); and ophthalmologic systems (P = .041).ConclusionsIncreased overall health complexity, public insurance status, and need for social work support were identified as factors associated with NAM noncompletion. These variables can help identify patients at risk of noncompletion and empower providers to supply individualized support and resources.