ANNALS OF IBADAN POSTGRADUATE MEDICINE
Name of Author(s)
A.A. Olusanya1, A.I. Michael2, O.A. Olawoye2,3 and V.I. Akinmoladun1
Background: Exogenous factors occurring in the antenatal period could be contributory to the formation of orofacial cleft. This study sought to determine the antenatal events in mothers that may have contributed to orofacial cleft deformity of their children.
Methodology: It was a prospective observational cross sectional study of consenting mothers of babies with orofacial cleft who met the inclusion criteria. The study instrument was a questionnaire.
Results: Seventy-two mothers participated in the study. Most of these mothers were below 35 years of age and more than half, 43 (59.7%) were of the low intermediate socioeconomic status. Although majority, 70 (97.2) of the mothers had antenatal care, the mean gestational age at commencement of antenatal care was 4 months. Almost all, 69 (95.8%) mothers had ultrasound scans however the detection of the orofacial cleft was in only 2 (2.8%) mothers. The commonest medication taken was haematinics, 26 (36.1%). Herbal medication, 15 (20.8%) and antimalarial, 12 (16.7%) were the other drugs more frequently taken. The mean age of pregnancy at commencement of these medications was 3.6 months.
Conclusion: Although uptake of antenatal service was common practice among mothers of babies with orofacial clefts in this study, no antenatal predisposing factors were identified.
Keywords: Cleft lip and palate, Antenatal events, Mothers
Dr. A.I. Michael
Department of Plastic, Reconstructive and Aesthetic Surgery,
University College Hospital, Ibadan, Oyo State, Nigeria
Orofacial cleft is the commonest craniofacial congenital anomaly, which occurs approximately one in every 700 – 1,000 births1,2. The precise aetiology is unknown possibly due to the heterogeneous nature of the anomaly.2,3 However several risk factors have been suggested for this anomaly.2,4-7, These factors have been reported variously among different populations as predisposition such as family history of cleft, parental tobacco smoking, alcohol intake during pregnancy, increased maternal and paternal age, smoking, exposure to insecticides, nutritional deficiencies, low socioeconomic status and residence in particular locations/geographical locations.4,6-8 This study was undertaken to describe the antenatal events in a Nigerian population of mothers with babies with orofacial clefts. Knowledge of practices among mothers of babies with cleft anomalies may aid in the identification of possible aetiological factors and steps that could be taken to reduce the incidence of these anomalies in our environment.
MATERIALS AND METHODS
This was a prospective observational cross-sectional study of consenting mothers of babies with orofacial cleft who presented to the cleft clinic of the hospital from 2014 to 2015. Antenatal events in this study were defined as health related events both experienced and performed by the mothers in the antenatal period. Mothers with babies older than six months of age were excluded from the study because of the reliability of being able to recall the prenatal events. Questions pertaining to age of the parents and infants, socioeconomic status of the mothers, uptake of antenatal services, use of medications and traditional concoctions during pregnancy, occurrence of illness and trauma during pregnancy were asked. Documentations of the anomalies were also recorded regarding the type of orofacial cleft, laterality and extent of cleft anomalies as well as the frequency of other associated congenital anomalies. The socioeconomic status (SES) was categorized according to a modification of the classification by Ogunlesi, which described five classes.9 These classes were recategorized as in Table 1; high-intermediate SES (Classes 1 and 2), intermediate SES (Classes 3) lowintermediate SES (Class 4) and low (Class 5). An addition class of High SES was introduced and dependents were not categorized into a particular class (Table 1). The type of cleft was described as cleft lip with or without cleft palate (CL±P), cleft palate only (CP) (Bell) and rare craniofacial clefts. Categorical variables were compared using Chi square and multiple means were compared using ANOVA. Significance was set at p <0.05.