Newly Identified Developmental Delays in a Large Population of Children With Nonsyndromic Cleft Lip and Palate.

Background: Nonsyndromic cleft lip and/or palate (NSCLP) is the most common congenital craniofacial anomaly. Early recognition of developmental delays associated with NSCLP is critical for counseling and management. This study investigates developmental delays in a large population of children with NSCLP.

Methods: This is an institutional review board-approved, retrospective analysis of children 5-21 years of age with a diagnosis of NSCLP. Demographic and clinical variables were collected for patients and a control group without NSCLP from the 2018 National Survey of Children's Health (NSCH) database.

Results: A total of 617 patients with NSCLP subjects and 29,147 NSCH participants were included. Among orofacial clefts, 45.2% were unilateral cleft lip and palate, followed by isolated cleft palate (30%), bilateral cleft lip and palate (16.4%), and isolated cleft lip (8.4%). NSCLP children with isolated cleft lip (odds ratio [OR]: 3.97), unilateral cleft lip and palate (OR: 2.17) and bilateral cleft lip and palate (OR: 2.91) had significantly higher odds of being diagnosed with attention-deficit hyperactivity disorder than the NSCH cohort. Rates of autism/pervasive developmental disorder were higher in children with isolated cleft lip than cleft lip and palate (11.5% versus 4.7%, P = 0.06), but this association was not significant. Children with isolated cleft palate had higher rates of intellectual disability, speech delay, global developmental delay, cerebral palsy, and hearing loss compared with the NSCH cohort (P < 0.05).

Conclusions: Higher rates of attention disorders and developmental delays in children with NSCLP highlight the importance of proper risk assessment and multidisciplinary management for this population.