Cleft Lip and Palate
Cleft lip (CL) and palate (CP) occurs as part of many other malformation syndromes in a non-specific manner more frequently than would be expected. The aetiology of isolated clefts, without syndromic features or family history, however, is likely a result of genetic and environmental factors.
The population incidence is:
- 1 in 500 – 1 in 1000 for cleft lip (with or without cleft palate). It is unilateral in 80% of cases with the left side more commonly affected. Males are often ore severe.
- 1 in 2500 for isolated cleft palate. The spectrum of abnormalities ranges from bifid uvula to submucous cleft to velopharyngeal insufficiency (regurgitation f milk in children to nasal speech in adults).
Recent case control studies have shown that periconceptual folate supplementation has a 47% risk reduction in CL/P in offspring of when compared to no maternal folate supplementation.
- A dose of 5mg/day is recommended for women with a previous occurrence and 400mcg/day where there is no prior history.