ArticleChildren (Basel, Switzerland)2026
Prenatal Ultrasound Detection and Neonatal Nasogastric Tube Feeding Follow Opposite Gradients Across Orofacial Cleft Phenotypes: A Nationally Ascertained Referral-Centre Cohort Study.
Article in Children (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesCleft palate is developmentally and clinically distinct from cleft lip with or without cleft palate. Prenatal ultrasound reliably identifies clefts involving the lip but performs poorly for the secondary palate, whereas early feeding difficulty is concentrated in palatal clefts. These two observations have not previously been quantified within a single cohort. We aimed to determine whether prenatal detectability and neonatal feeding support requirements follow opposite gradients across cleft phenotypes.
methodsWe conducted an ambispective study of a nationally ascertained referral-centre cohort of 328 consecutive children with an orofacial cleft and no clinically recognised syndrome, managed at the national referral centre for cleft surgery in Croatia. The cohort comprises children reaching surgical care and is not a population-based birth registry. Documented prenatal ultrasound diagnosis and feeding method during the first weeks of life were abstracted from medical records; cleft phenotype was confirmed by clinical examination. Proportions were compared with chi-square tests and exact binomial confidence intervals, and factors independently associated with each outcome were identified by multivariable logistic regression.
resultsOverall prenatal detection was 76/316 (24.1%; 95% CI 19.4-29.2). Detection differed markedly by phenotype: 38.2% for cleft lip only, 34.0% for cleft lip and palate and 2.0% for cleft palate only (
conclusionsPrenatal detectability and neonatal nasogastric tube use follow opposite gradients across cleft phenotypes. Children with cleft palate only are simultaneously the least likely to be identified before birth and the most likely to require assisted feeding, and almost all tube-fed infants arrive without a prenatal diagnosis. These findings support, as a practice consideration, routine structured neonatal feeding assessment for every newborn with a palatal cleft irrespective of prenatal findings.
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