Associations Between Anthropometric Growth Patterns and Feeding Complexity with Readmission Following Primary Palatoplasty

Objective To evaluate whether preoperative anthropometric measures and feeding-related variables are associated with readmission following primary palatoplasty. Design Retrospective cohort study Setting Tertiary pediatric craniofacial center. Participants Infants undergoing primary palatoplasty between 2015 and 2022 with documented weight-for-age (WAZ) and height-for-age (HAZ) z scores. Main Outcome Measures Readmission within 30 days of primary palatoplasty. Multivariable logistic regression evaluated associations with anthropometric, demographic, and feeding-related covariates. Results Among 282 patients, 43 (15.2%) experienced 30-day readmission. Higher WAZ was associated with increased odds of readmission (OR: 1.87; 95% CI: 1.23–2.84; p = .003), whereas higher HAZ was associated with decreased odds (OR: 0.66; 95% CI: 0.49–0.90; p = .009). Concentrated formula use was also associated with increased odds (OR: 2.92; 95% CI: 1.18–7.19; p = .020). These associations persisted among patients without a syndromic diagnosis. Nutrition- or feeding-related concerns accounted for 19 of 43 readmissions (44.2%) and higher WAZ and lower HAZ remained associated with this outcome. Conclusions Higher WAZ, lower HAZ, and concentrated formula use were associated with readmission following primary palatoplasty with similar anthropometric associations observed among patients without a syndromic diagnosis and for nutrition- or feeding-related readmissions. Anthropometric variables should be interpreted alongside the feeding and nutritional support required during surgical preparation and may help identify patients requiring closer perioperative feeding surveillance.