Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Frequency of anemia and micronutrient deficiency among children with cleft lip and palate: a single-center cross-sectional study from Uttarakhand, India

  • Chattopadhyay, Debarati (Department of Burns and Plastic Surgery, All India Institute of Medical Sciences) ;
  • Vathulya, Madhubari (Department of Burns and Plastic Surgery, All India Institute of Medical Sciences) ;
  • Naithani, Manisha (Department of Biochemistry, All India Institute of Medical Sciences) ;
  • Jayaprakash, Praveen A (Department of Burns and Plastic Surgery, All India Institute of Medical Sciences) ;
  • Palepu, Sarika (Department of Community Medicine, Government Medical College) ;
  • Bandyopadhyay, Arkapal (Department of Pharmacology, All India Institute of Medical Sciences) ;
  • Kapoor, Akshay (Department of Burns and Plastic Surgery, All India Institute of Medical Sciences) ;
  • Nath, Uttam Kumar (Department of Medical Oncology Hematology, All India Institute of Medical Sciences)
  • Received : 2020.08.21
  • Accepted : 2021.02.15
  • Published : 2021.02.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Children with cleft lip and/or palate can be undernourished due to feeding difficulties after birth. A vicious cycle ensues where malnutrition and low body weight precludes the child from having the corrective surgery, in the absence of which the child fails to gain weight. This study aimed to identify the proportion of malnutrition, including the deficiency of major micronutrients, namely iron, folate and vitamin B12, in children with cleft lip and/or palate and thus help in finding out what nutritional interventions can improve the scenario for these children. Methods: All children less than 5 years with cleft lip and/or cleft palate attending our institute were included. On their first visit, following were recorded: demographic data, assessment of malnutrition, investigations: complete blood count and peripheral blood film examination; serum albumin, ferritin, iron, folate, and vitamin B12 levels. Results: Eighty-one children with cleft lip and/or palate were included. Mean age was 25.37±21.49 months (range, 3-60 months). In 53% of children suffered from moderate to severe wasting, according to World Health Organization (WHO) classification. Iron deficiency state was found in 91.6% of children. In 35.80% of children had vitamin B12 deficiency and 23.45% had folate deficiency. No correlation was found between iron deficiency and the type of deformity. Conclusion: Iron deficiency state is almost universally present in children with cleft lip and palate. Thus, iron and folic acid supplementation should be given at first contact to improve iron reserve and hematological parameters for optimum and safe surgery.

Keywords

References

  1. Mossey P, Little J. Addressing the challenges of cleft lip and palate research in India. Indian J Plast Surg 2009;42 Suppl:S9-18. https://doi.org/10.1055/s-0039-1699372
  2. Sharma R. Birth defects in India: hidden truth, need for urgent attention. Indian J Hum Genet 2013;19:125-9. https://doi.org/10.4103/0971-6866.116101
  3. Reddy SG, Reddy LV, Reddy RR. Developing and standardizing a center to treat cleft and craniofacial anomalies in a developing country like India. J Craniofac Surg 2009;20(Suppl2): 1664-7. https://doi.org/10.1097/SCS.0b013e3181b2d6c7
  4. International Institute for Population Science. National Family Health Survey (NFHS-3), 2005-06 [Internet]. Mumbai: International Institute for Population Science; c2006 [cited 2021 Feb 15]. Available from: http://rchiips.org/nfhs/nfhs3.shtml.
  5. Ahmad MS, Farooq H, Maham SN, Qayyum Z, Waheed A, Nasir W. Frequency of anemia and iron deficiency among children starting first year of school life and their association with weight and height. Anemia 2018;2018:8906258. https://doi.org/10.1155/2018/8906258
  6. Stewart BT, Carlson L, Hatcher KW, Sengupta A, Vander Burg R. Estimate of unmet need for cleft lip and/or palate surgery in India. JAMA Facial Plast Surg 2016;18:354-61. https://doi.org/10.1001/jamafacial.2016.0474
  7. Reid J. A review of feeding interventions for infants with cleft palate. Cleft Palate Craniofac J 2004;41:268-78. https://doi.org/10.1597/02-148.1
  8. Montagnoli LC, Barbieri MA, Bettiol H, Marques IL, de Souza L. Growth impairment of children with different types of lip and palate clefts in the first 2 years of life: a cross-sectional study. J Pediatr (Rio J) 2005;81:461-5. https://doi.org/10.2223/JPED.1420
  9. Pandya AN, Boorman JG. Failure to thrive in babies with cleft lip and palate. Br J Plast Surg 2001;54:471-5. https://doi.org/10.1054/bjps.2001.3618
  10. Seetharaman N, Chacko TV, Shankar SLR, Mathew AC. Measuring malnutrition-the role of Z scores and the composite index of anthropometric failure (CIAF). Indian J Community Med 2007;32:35-9. https://doi.org/10.4103/0970-0218.53392
  11. International Institute for Population Science. National Family Health Survey (NFHS-4), 2015-16 [Internet]. Mumbai: International Institute for Population Science; c2017 [cited 2021 Feb 15]. Available from: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf.
  12. India State-Level Disease Burden Initiative CGF Collaborators. Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000-2017. EClinicalMedicine 2020;22:100317. https://doi.org/10.1016/j.eclinm.2020.100317
  13. Kotecha PV. Nutritional anemia in young children with focus on Asia and India. Indian J Community Med 2011;36:8-16. https://doi.org/10.4103/0970-0218.80786
  14. Dvivedi J, Dvivedi S. A clinical and demographic profile of the cleft lip and palate in sub-Himalayan India: a hospital-based study. Indian J Plast Surg 2012;45:115-20. https://doi.org/10.4103/0970-0358.96602
  15. Singhal S, Negi G, Chandra H, Chandra S, Gaur DS, Rajan M. Hematological parameters in patients of cleft lip and cleft palate with special reference to eosinophil counts. J Craniofac Surg 2014;25:103-5. https://doi.org/10.1097/SCS.0b013e3182a2eb3c
  16. United Nations Children's Fund; United Nations University; World Health Organization (WHO). Iron deficiency anaemia: assessment, prevention, and control: a guide for programme managers. Geneva: WHO; 2001.
  17. World Health Organization (WHO). Assessing the iron status of populations: report of a joint World Health Organization/Centers for Disease Control and Prevention technical consultation on the assessment of iron status at the population level. 2nd ed. Geneva: WHO; 2004.
  18. Sahu SK, Kumar SG, Bhat BV, Premarajan KC, Sarkar S, Roy G, et al. Malnutrition among under-five children in India and strategies for control. J Nat Sci Biol Med 2015;6:18-23. https://doi.org/10.4103/0976-9668.149072

Cited by

  1. Breastfeeding Promotion and Nursing Care for Infants with Cleft Palate and/or Cleft Lip in Northeastern Craniofacial Center, Thailand vol.15, pp.1, 2021, https://doi.org/10.2174/1874434602115010149