Anthropometric and micronutrient assessment in pediatric patients with cleft lip and palate in a tertiary care hospital of Haryana, India

Abstract

Introduction: Cleft lip (CL) and/or cleft palate (CP) are the most common visible craniofacial anomalies throughout the world. CL and CP occur due to a failure of the skeletal components of the mid-face to fuse. The affected individual may have an isolated defect or a combination of both. These children can be undernourished due to feeding difficulties after birth. The growth problems of children with clefts have largely been attributed to inadequate nutrition. The aim of the study is to assess the anthropometric status and micronutrient deficiencies in children with cleft lip and palate. Methods: This is a cross-sectional study of 18 months duration conducted at SGT medical college, Gurugram, a tertiary care center in Haryana, India between June 2020 to December 2021 involving the assessment of patients with cleft lip and palate between the age of 3 months to 5 years of either gender who visited pediatric unit for complete evaluation before surgery. A total of 100 patients were enrolled in the study and the following information was recorded: age, gender, hemoglobin, serum vitamin D3 level, serum ferritin, and serum vitamin B12 level. Results: A total of 100 patients were included in the study, of which, 53 (53%) were males and 47 (47%) were females. Anthropometrically, in our study, 83% of patients had moderate to severe wasting, according to WHO classification. Anemia was prevalent in 71.1% of cases in the current study. Vitamin D3 deficiency was seen in 88% of the study population, while 37% of cases had Vitamin B12 deficiency. The correlation between anthropometric assessment and nutritional deficiency suggested that children of cleft lip and palate with severe wasting had significant iron deficiency anemia as well as vitamin B12 deficiency. However, vitamin D deficiency was not statistically significant in severe wasting group. Conclusion: A large number of children with cleft lip and/or palate are not exclusively breastfed due to anatomical deficits. They need supplemental Iron and vitamin D to meet the demands. Macro and micronutrient deficiencies along with recurrent infections, lead to moderate to severe wasting and stunting in these children causing severe malnutrition with complications and failure to thrive.

Keywords

• anthropometry
• cleft lip
• micronutrient
• palate