Impact of Prenatal Care on Newborn Complications for Infants with Cleft Lip with or Without Cleft Palate

Abstract

ObjectiveTo determine the association between prenatal care and cleft lip with or without cleft palate (CL ± P) and examine differences in newborn complications among infants diagnosed with CL ± P as a function of prenatal careDesignPopulation-based retrospective cohort studySetting2018 United States National Vital Statistics System—Natality component (NVSS-N) was used to examine nationwide birth certificate dataParticipants3,414,338 infants from the 2018 National Vital Statistics System, of which 1,699 had CL ± PMain Outcome MeasureDiagnosis of CL ± P and presence of newborn complications as a function of prenatal careResultsSignificant differences were found among various infant- and mother-specific variables when baseline comparisons were made between infants with and without CL ± P. After controlling for baseline differences, results indicated decreased odds of a diagnosis of CL ± P in cases where overall adequate prenatal care was obtained (OR = .841; 95% CI .757, .934), including prenatal care beginning in the 1sttrimester (OR = .839; 95% CI .750, .939) and an adequate number of prenatal visits received (OR = .864; 95% CI .764, .976). Of infants with CL ± P, reduced odds of the infant admitted to the neonatal intensive care unit (OR = .777; 95% CI .613, .985) or transferred (OR = .601; 95% CI .407, .888) were apparent when adequate prenatal care was received.ConclusionResults suggest adequate prenatal care not only reduces the likelihood of CL ± P in infants but may also decrease the severity of negative outcomes in infants diagnosed with CL ± P. These findings emphasize necessity for adequate prenatal care.