Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum

Johanna L. Ellefson; Samantha J. Barr; Maya N. Matabele; Sabrina X. Huang; Gisselle A. Garcia; Elle C. Nuttall; Manasa Venkatesh; Inna M. Lobeck; Deborah Kacmarynski; Michael D. Puricelli

doi:10.1177/10556656251350597

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Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum

Journal article

Peer reviewed

Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum

Johanna L. Ellefson, Samantha J. Barr, Maya N. Matabele, Sabrina X. Huang, Gisselle A. Garcia, Elle C. Nuttall, Manasa Venkatesh, Inna M. Lobeck, Deborah Kacmarynski and Michael D. Puricelli

The Cleft palate-craniofacial journal, Vol.63(6), pp.1725-1732

06/2026

DOI: 10.1177/10556656251350597

PMID: 40619943

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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.

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Dentistry, Oral Surgery & Medicine

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum
Creators: Johanna L. Ellefson - University of Wisconsin–Madison
Samantha J. Barr - University of Wisconsin–Madison
Maya N. Matabele - University of Wisconsin–Madison
Sabrina X. Huang - University of Wisconsin–Madison
Gisselle A. Garcia - University of Wisconsin–Madison
Elle C. Nuttall - University of Wisconsin–Madison
Manasa Venkatesh - University of Wisconsin–Madison
Inna M. Lobeck - Sisters of Mercy Health System
Deborah Kacmarynski - University of Iowa
Michael D. Puricelli - University of Missouri–Kansas City
Resource Type: Journal article
Publication Details: The Cleft palate-craniofacial journal, Vol.63(6), pp.1725-1732
DOI: 10.1177/10556656251350597
PMID: 40619943
NLM abbreviation: Cleft Palate Craniofac J
ISSN: 1055-6656
eISSN: 1545-1569
Publisher: Sage
Number of pages: 8
Grant note: T32DC009401; 5 T32 DC 9401-15 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
Language: English
Electronic publication date: 07/07/2025
Date published: 06/2026
Academic Unit: Stead Family Department of Pediatrics; Craniofacial Anomalies Research Center; Otolaryngology
Record Identifier: 9984845650402771

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