Catch-up Growth Pattern in Cleft Palate: A Longitudinal Study from Infancy to Adolescence.

OBJECTIVE: To characterize the patterns of somatic catch-up growth from infancy to adolescence in patients with cleft palate (CP).

STUDY DESIGN: We assessed 474 non-syndromic patients with isolated cleft palate (ICP, n=69) and unilateral and bilateral cleft lip and palate (UCLP, n=271; BCLP, n=134) who underwent palatoplasty between 1988 and 2017 and had longitudinal physical growth data at birth (T0), cheiloplasty (T1), palatoplasty (T2), childhood (T3), and adolescence (T4). The z-scores of weight (ZWT), height (ZHT), and body mass index (ZBMI) were compared among the CP types (ICP, UCLP, and BCLP) and time points (T1, T2, T3, and T4). Subgroup analyses were performed to investigate the growth of malnourished patients (z-score < -1) at T1 or T2. A generalized linear model was used to investigate the effects of gestational age and cardiac anomalies on the longitudinal changes in ZHT and ZBMI.

RESULTS: Regardless of the time point, the overall ZHT, ZWT, and ZBMI approximated 0 in all CP types, indicating few differences from the mean values of non-cleft children. Significant catch-up growth occurred in ZHT and ZWT from T1 to T4 for all CP types (all P<0.05). Despite the recovery of ZHT and ZBMI in most malnourished patients, these values remain relatively low until adolescence. Patients who were born at preterm stage or had surgically repaired cardiac anomalies grew well.

CONCLUSION: Even in infants with CP and malnutrition, preterm birth, or cardiac anomalies, rapid catch-up growth can occur prior to palatoplasty with the help of comprehensive cleft care.