Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum.
Document Type
Article
Publication Date
6-2026
Identifier
DOI: 10.1177/10556656251350597
Abstract
Objective Cleft spectrum anomalies are sometimes associated with airway obstruction at birth. Modified delivery may facilitate advanced treatment, but there is insufficient data examining its use in patients with isolated cleft lip (iCL), isolated cleft palate (iCP), or cleft lip and palate (CLP). This study aims to address this gap.
Design Deidentified birth hospitalization data were extracted from the Healthcare Cost and Utilization Project Kids' Inpatient Database (2000-2019). Patients were identified using ICD codes and categorized as iCL, iCP, and CLP. Incidence, demographics, airway procedures on day of life (DOL) 0 or 1, complications, and survival were examined. The Rao-Scott chi-square test was used for comparison between unaffected and cleft spectrum groups.
Participants The sample included 26 943 508 individuals, excluding out-of-hospital births, transfers, and individuals with cleft in association with mandibular anomalies or syndromic disorders.
Results The weighted incidence for isolated cleft spectrum was 1.3 per 1000 birth visits. Airway intervention on DOL 0 or 1 occurred in 5.0% of the cleft group compared to 1.7% in the unaffected group (P ≤ .01). Preterm delivery occurred more frequently among patients with cleft spectrum but did not account for the elevated rate of airway intervention. Among individuals who received an airway intervention, hypoxic complications or mortality were more frequent in patients with cleft spectrum.
Conclusions Individuals with isolated cleft spectrum experience higher rates of perinatal airway interventions with poorer outcomes than unaffected individuals. These findings may affect delivery planning, especially regarding the location and availability of neonatal services at delivery.
Journal Title
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
Volume
63
Issue
6
First Page
1725
Last Page
1732
MeSH Keywords
Humans; Airway Obstruction; Cleft Palate; Cleft Lip; Incidence; United States; Databases, Factual; Male; Infant, Newborn; Retrospective Studies; Cohort Studies
PubMed ID
40619943
Keywords
airway obstruction; cleft lip; cleft lip and palate; cleft palate; intervention; pediatrics; upper airway obstruction
Recommended Citation
Ellefson JL, Barr SJ, Matabele MN, et al. Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum. Cleft Palate Craniofac J. 2026;63(6):1725-1732. doi:10.1177/10556656251350597
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