Cleft lip and palate severity and COVID-19 related risk factors in five Arab Countries

Abstract

Abstract Background: Little is known about factors associated with the severity of cleft lip with or without cleft palate (CL/P) especially during COVID-19 pandemic with its dramatic changes. Objectives: The aim of this multi-national study is to measure the association between CL/P severity, COVID-19 infection, and fear of COVID-19 in Five-Arab countries. Methods: This cross-sectional study took place in major governmental hospitals in Five-Arab countries from November-2020 to April-2023. Participants were infants born with CL/P and their mothers who were in their 1sttrimester during the COVID-19 pandemic. Clinical examination was carried out and CL/P cases were grouped according to phenotype (cleft lip and palate (CLP) versus cleft lip (CL)), cleft extension (incomplete versus complete) and site (unilateral versus bilateral) to assess severity. Information on maternal COVID-19 infection and fear of COVID-19 were gathered. Results: The study recruited 274 CL/P infants. Maternal COVID-19 infection during pregestation and 1st trimester was significantly associated with higher odds of CL/P severity (AOR=2.707; P=0.002) than mothers without COVID-19 infection. Using supplements during pregnancy showed protective effect (AOR=0.573; P=0.065). Conclusion: Mothers infected with COVID-19 before and during pregnancy had more than two folds’ higher odds of having infant with a more severe CL/P phenotype.