Cleft Lip and Palate: Analyzing the Impact of Family History and Cousin Marriages: Cleft Lip and Palate: Family History and Cousin Marriages

Rabia Anjum; Saqib Mehmood; Abdul Hanan Nagi; Saima Chaudhry

doi:10.54393/pjhs.v7i6.2814

Authors

Rabia Anjum Department of Oral Pathology, University of Health Sciences, Lahore
Saqib Mehmood Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
Abdul Hanan Nagi Department of Histopathology, University of Health Sciences, Lahore, Pakistan
Saima Chaudhry Department of Oral Pathology, University of Health Sciences, Lahore

DOI:

https://doi.org/10.54393/pjhs.v7i6.2814

Keywords:

Cleft Lip and Palate, Family History, Cousin Marriages, Maternal Folic Acid Intake

Abstract

Cleft lip and palate (CLP) are prevalent birth disorders and have significant impacts on the individuals and their families. Objectives: To identify the trends of cleft lip and palate and to examine the effects of family history and the marriage of cousins. Methods: This cross-sectional study was carried out in the Department of Oral Pathology, University of Health Sciences, Lahore. Four hundred children between the ages of 0 and 20 years were included. The following data were taken: demographic and clinical, such as age, sex, type of cleft, maternal folic acid intake, family history of cleft lip and/or palate or other congenital anomalies, and parental consanguinity. Results: The mean age of the participants was 55.79 ± 54.3 months. Among them, 214 (53.5%) were male, and 186 (46.5%) were female. In terms of cleft pattern, cleft lip and palate were most common, affecting 247 (61.8%) individuals, compared to those with only cleft lip or cleft palate. A positive family history was reported in 89 (22.3%) of the cases. Only 60 (15%) of the mothers had taken folic acid during pregnancy, and cousin marriages were noted among the parents of 309 (77.3%) children. Conclusions: CLP is more commonly observed in individuals with a positive family history and those whose parents are biologically related. A considerable proportion of affected children had parents who were cousins, suggesting that consanguinity may be a contributing factor to CLP. Additionally, a significant number of mothers did not receive folic acid supplementation during pregnancy, which is a modifiable risk factor.

References

AlHayyan WA, Al Hayek S, Alotaibi SS, AlGhanim SA. Birth Prevalence of Orofacial Cleft in A Tertiary Hospital in Riyadh, Saudi Arabia: A Retrospective Audit. The Saudi Dental Journal. 2021 Dec; 33(8): 954-7. doi: 10.1016/j.sdentj.2021.08.005.

Fayyaz GQ, Gill NA, Ishaq I, Ganatra MA, Mahmood F, Kashif M et al. A Model Humanitarian Cleft Mission: 312 Cleft Surgeries in 7 Days. Plastic and Reconstructive Surgery–Global Open. 2015 Mar; 3(3): e313. doi: 10.1097/GOX.0000000000000282.

Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of Lip and Palate: A Review. Journal of Family Medicine and Primary Care. 2020 Jun; 9(6): 2621-5. doi: 10.4103/jfmpc.jfmpc_472_20.

Al Jadidi L, Sabrish S, Shivamurthy PG, Senguttuvan V. The Prevalence of Malocclusion and Orthodontic Treatment Need in Omani Adolescent Population. Journal of Orthodontic Science. 2018 Jan; 7(1): 21. doi: 10.4103/jos.JOS_44_18.

Emeka CI, Adeyemo WL, Ladeinde AL, Butali A. A Comparative Study of Quality of Life of Families with Children Born with Cleft Lip and/or Palate Before and After Surgical Treatment. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2017 Aug; 43(4): 247. doi: 10.5125/jkaoms.2017.43.4.247.

AlHammad Z, Suliman I, Alotaibi S, Alnofaie H, Alsaadi W, Alhusseini S et al. The Prevalence of Non-Syndromic Orofacial Clefts and Associated Congenital Heart Diseases of A Tertiary Hospital in Riyadh, Saudi Arabia. The Saudi Dental Journal. 2021 Mar; 33(3): 137-42. doi: 10.1016/j.sdentj.2019.12.002.

Baig S, Bhutta MF, Hashmi FP, Khan K, Iqbal UA, Bhatti ZI. Frequency of Cleft Lip and Cleft Palate in Pakistan. The Professional Medical Journal. 2022 Apr; 29(05): 671-5. doi: 10.29309/TPMJ/2022.29.05.6908.

Jamilian A, Sarkarat F, Jafari M, Neshandar M, Amini E, Khosravi S et al. Family History and Risk Factors for Cleft Lip and Palate Patients and Their Associated Anomalies. Stomatologija. 2017 Jan; 19(3): 78-83.

Burg ML, Chai Y, Yao CA, Magee III W, Figueiredo JC. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate. Frontiers in Physiology. 2016 Mar; 7: 67. doi: 10.3389/fphys.2016.00067.

Moeed K, Ahmad W, Haris M, Muzadar S, Wazir NU, Imran S. Epidemiological Trends in Cleft Lip and Cleft Palate Frequency: An Analytical Perspective. Annals of Punjab Medical College. 2023 Dec; 17(4): 550-3. doi: 10.29054/apmc/2023.1371.

Pool SM, der Lek LM, de Jong K, Vermeij-Keers C, Mouës-Vink CM. Embryologically Based Classification Specifies Gender Differences in the Prevalence of Orofacial Cleft Subphenotypes. The Cleft Palate Craniofacial Journal. 2021 Jan; 58(1): 54-60. doi: 10.1177/1055665620935363.

Saeed OB, Moore MG, Zawahrah H, Tayem M, Kavoosi T, Van Aalst JA. The Influence of Consanguinity on Familial Clefting among Palestinians. The Cleft Palate-Craniofacial Journal. 2019 Sep; 56(8): 1072-9. doi: 10.1177/1055665619838381.

Belachew FK, Gerbu DG, Woldesenbet EB, Abay ES, Maswime S, Eshete M. Clinical Profiles of Individuals with Orofacial Clefts: Results from Fourteen Eastern African countries. Global Pediatrics. 2023 Sep; 5: 100067. doi: 10.1016/j.gpeds.2023.100067.

Kianifar H, Hasanzadeh N, Jahanbin A, Ezzati A, Kianifar H. Cleft Lip and Palate: A 30-Year Epidemiologic Study in North-East of Iran. Iranian Journal of Otorhinolaryngology. 2015 Jan; 27(78): 35.

Trezena S, Machado RA, de Almeida Reis SR, Scariot R, Rangel AL, de Oliveira FE et al. Isolated Nonsyndromic Cleft Palate: Multicenter Epidemiological Study in Brazil. BioMed Central Oral Health. 2023 Jul; 23(1): 486. doi: 10.1186/s12903-023-03197-3.

Yáñez-Vico RM, Iglesias-Linares A, Gómez-Mendo I, Torres-Lagares D, González-Moles MÁ, Gutierrez-Pérez JL et al. A Descriptive Epidemiologic Study of Cleft Lip and Palate in Spain. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 2012 Nov; 114(5): S1-4. doi: 10.1016/j.tripleo.2011.07.046.

Martelli DR, Machado RA, Swerts MS, Rodrigues LA, de Aquino SN, Júnior HM. Non-Syndromic Cleft Lip and Palate: Relationship Between Sex and Clinical Extension. Brazilian Journal of Otorhinolaryngology. 2012 Sep; 78(5): 116-20. doi: 10.5935/1808-8694.20120018.

Ferrari-Piloni C, Barros LA, Jesuíno FA, Valladares-Neto J. Prevalence of Cleft Lip and Palate and Associated Factors in Brazil's Midwest: A Single-Center Study. Brazilian Oral Research. 2021 Apr; 35: e039. doi: 10.1590/1807-3107bor-2021.vol35.0039.

Silva CM, de Moraes Pereira MC, de Queiroz TB, das Neves LT. Can Parental Consanguinity be a Risk Factor for the Occurrence of Nonsyndromic Oral Cleft? Early Human Development. 2019 Aug; 135: 23-6. doi: 10.1016/j.earlhumdev.2019.06.005.

Sakran KA, Abotaleb BM, Al-Rokhami RK, Hsieh TY, Al-Wesabi MA, Mohammed AA et al. Analysis of Environmental Exposures for Nonsyndromic Cleft Lip and/or Palate: A Case-Control Study. Iranian Journal of Public Health. 2022 Mar; 51(3): 578.

El Goundali K, Chebabe M, Laamiri FZ, Hilali A. The Determinants of Consanguineous Marriages among the Arab Population: A Systematic Review. Iranian Journal of Public Health. 2022 Feb; 51(2): 253. doi: 10.18502/ijph.v51i2.8679.

Sadiq H, Ijaz R, Ayub A. Patterns of Orofacial Clefts and Associated Risk Factors in Pakistan: An Institutional Experience. Journal of Cleft Lip Palate and Craniofacial Anomalies. 2022 Jul; 9(2): 145-50. doi: 10.4103/jclpca.jclpca_1_22.

Kurniati M, Pramono RC, Sosiawan A, Tirtaningsih NW. The Genetic Aspect of Non-Syndromic Cleft Lip and Palate Towards Candidate Genes in the Etiology: A Literature Review. Indian Journal of Forensic Medicine and Toxicology. 2021; 15(3): 3604-8. doi: 10.37506/ijfmt.v15i3.15859.

Slavec L, Karas Kuželički N, Locatelli I, Geršak K. Genetic Markers for Non-Syndromic Orofacial Clefts in Populations of European Ancestry: A Meta-Analysis. Scientific Reports. 2022 Jan; 12(1): 1214. doi: 10.1038/s41598-021-02159-5.

Alyami B, Ali-Hassan M, Al-Mahri M, Alyami F, Alharieth S. Risk Indicators for Syndromic and Nonsyndromic Orofacial Clefts in Southern Province of Saudi Arabia. Journal of Cleft Lip Palate and Craniofacial Anomalies. 2019 Jan; 6(1): 51-5. doi: 10.4103/jclpca.jclpca_31_18.

Maranhão SC, Sá J, Cangussú MC, Coletta RD, Reis SR, Medrado AR. Nonsyndromic Oral Clefts and Associated Risk Factors in the State of Bahia, Brazil. European Archives of Paediatric Dentistry. 2021 Apr; 22(2): 121-7. doi: 10.1007/s40368-020-00522-0.

Neogi SB, Singh S, Pallepogula DR, Pant H, Kolli SR, Bharti P et al. Risk Factors for Orofacial Clefts in India: A Case–Control Study. Birth Defects Research. 2017 Oct; 109(16): 1284-91. doi: 10.1002/bdr2.1073.

Bakhshani S. Consanguineous Marriage and the Risk of Parents Having Children with Cleft Lip and Palate. International Journal of High-Risk Behaviors and Addiction. 2021 Jan; 10(10). doi: 10.5812/ijhrba.114912.