Range and Frequency of Congenital Malformations Among Children With Cleft Lip and/or Palate

Objective To assess the range and frequency of additional congenital malformations identified among children born alive with CL/P. Design Analysis of patient-level data from a national registry of cleft births linked to national administrative data of hospital admissions. Setting National Health Service, England. Patients Children born between 2000 and 2012 receiving cleft care in English NHS hospitals. Outcome Measures The proportion of children with ICD-10 codes for additional congenital malformations, according to cleft type. Results The study included 9403 children. Of these 2114 (22.5%) had CL +/- A, 4509 (48.0%) had CP, 1896 (20.2%) had UCLP, and 884 (9.4%) had BCLP. A total of 3653 (38.8%) children had additional congenital malformations documented in their hospital admission records. The prevalence of additional congenital malformations was greatest among children with CP (53.0%), followed by those with BCLP (33.5%), UCLP (26.3%), and then CL +/- A (22.2%) (P < .001). Among those with UCLP, children with right-sided clefts were more likely to have additional malformations than those with left-sided clefts (31.6% vs 23.0%, P < .001). Malformations of the skeletal system and circulatory system were most common, affecting 10.5% and 10.2% of the included children, respectively. A total of 16.8% of children had additional congenital malformations affecting 2 or more structural systems. Conclusions Congenital malformations are common among children born alive with a cleft, affecting over half of some cleft subgroups. Given the frequency of certain structural malformations, clinicians should consider standardized screening for these children. Establishing good links with pediatric and genetic services is recommended.