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

OBJECTIVE: To 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 care.

DESIGN: Population-based retrospective cohort study.

SETTING: 2018 United States National Vital Statistics System-Natality component (NVSS-N) was used to examine nationwide birth certificate data.

PARTICIPANTS: 3,414,338 infants from the 2018 National Vital Statistics System, of which 1,699 had CL ± P.

MAIN OUTCOME MEASURE: Diagnosis of CL ± P and presence of newborn complications as a function of prenatal care.

RESULTS: Significant 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 1st trimester (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.

CONCLUSION: Results 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.