Micronutrient intake and food insecurity among mothers of infants with orofacial clefts: a cross-sectional study in Iran.

Cleft lip with or without cleft palate is a common congenital craniofacial anomaly influenced by genetic and environmental factors. This cross-sectional study investigated maternal micronutrient intake and household food insecurity among Iranian mothers of infants with orofacial clefts. Mothers of infants aged 0-12 months with cleft lip (CL), cleft palate (CP), or both were recruited from a referral hospital in Tehran (2019-2020). Dietary intake was assessed using a validated food frequency questionnaire, and food security was evaluated with a standardized instrument. Multinomial logistic regression was performed to examine associations. High prevalences of inadequate intake were observed for iron (91.0%), vitamin D (73.6%), vitamin A (70.6%), folate (60.2%), calcium (56.7%), and vitamin B6 (50.7%). Vitamin B12 inadequacy differed significantly across cleft types (p = 0.023), with higher prevalence in CP (35.8%) and CL/P (38.6%) compared with CL (19.2%). Food insecurity also differed significantly by cleft type (p = 0.024), with hunger reported in 42.9% of the CL/P, 24.5% of the CP, and 20.5% of the CL groups. In multinomial logistic regression (reference: CL), food insecurity without hunger was associated with lower odds of CL/P in the crude model (OR = 0.30, 95% CI: 0.14-0.65), although this association was attenuated after adjustment. However, a significant trend between increasing food insecurity and cleft severity persisted across all models (P-trend = 0.028). These findings highlight the importance of maternal nutrition and food security in preventive strategies.