Psychological and Neurodevelopmental Disorders in Cleft Lip and Palate

INTRODUCTION: Cleft lip and/or palate (CL/P) is associated with increased risk for psychological and neurodevelopmental disorders. This study used a large, multicenter database to evaluate comorbidities associated with various CL/P subtypes. METHODS: A retrospective analysis of the TriNetX database of 24,557 patients with cleft palate (CP), unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), unilateral cleft lip (UCL), and bilateral cleft lip (BCL). Rates of psychological and neurodevelopmental disorders were evaluated. Rates of these disorders were compared with those of 20,521,361 patients without CL/P. RESULTS: Patients with CP had significantly greater rates of attention deficit hyperactivity disorder, intellectual disability, and autism spectrum disorder (ASD), as well as speech, scholastic, and motor development disorders, compared with most other cleft subtypes. Patients with UCLP were more likely than those with BCLP to have specific comorbidities, with significantly higher rates of ASD, anxiety, and depression, as well as speech and scholastic developmental disorders. In comparison to the control cohort, CL/P patients had significantly higher rates of anxiety, depression, intellectual disability, and developmental disorders. Patients with CP had the most pronounced increase in prevalence of these conditions compared with controls. CONCLUSIONS: Findings suggest differences in psychological and neurodevelopmental outcomes across CL/P subtypes. CP was associated with significantly higher rates of multiple psychological and neurodevelopmental comorbidities. Such comorbidities are also more prevalent in patients with CL/P overall compared with controls. These results underscore the need for psychosocial and developmental screening, as well as multidisciplinary care, in patients with CL/P.