Association of Cleft Lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study (JECS).

Abstract

Background: Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of cleft lip and/or palate childbirths with bonding disorders still remains unclear. We examined the association between cleft lip and/or palate childbirth and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study. Methods: A cross-sectional study using the jecs-an-20180131 dataset was performed. A total of 104,065 foetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at 1 year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers with cleft lip and/or palate infants were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirth with cleft lip and/or palate. Results: No increased risk of bonding disorders was observed among all the mothers with cleft lip and/or palate childbirths (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), and advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate childbirths, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate childbirth with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. Conclusions: Cleft lip and/or palate childbirth may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.

Neurodevelopmental trajectories in children with cleft lip and palate: A longitudinal study based on the Japan Environment and Children's Study

“…The survey protocol, which was approved by the Institutional Review Board on Epidemiological Studies of the Ministry of the Environment (no. 100406001) and the ethics committees of all participating institutions, has been described in detail in previously published reports [18][19][20]. Written informed consent was obtained from all participants' mothers in the first trimester of pregnancy after informing them about the aim and procedure of the study.…”

“…The design of the questionnaire has been described in detail in previously published reports [18,19,22]. Socio-demographic characteristics, lifestyle, and health status variables in motherinfant dyads, which reportedly impact child neurodevelopment, were included in the linear mixed models as covariates.…”

“…It was incorporated in the Japan Environment and Children's Study, which is an ongoing nationwide, prospective birth cohort study that principally focuses on the influences of congenital anomalies (involving CL/P) on children's health and development. This nationwide survey reported that the prevalence of CL/P per 10,000 births was 24.8, and the longitudinal data included approximately 250 patients, although they had either syndromic or non-syndromic CL/P [17,18]. Moreover, the large-scale dataset allowed us to examine the potential impact of non-syndromic CL/P on children's neurodevelopment and compare it with that of relevant healthy controls, with adjustment for confounding covariates, such as health status and the socio-demographic characteristics of motherinfant dyads.…”

Prospective association between maternal bonding disorders and child toothbrushing frequency: A cross‐sectional study of the Japan Environment and Children’s Study

“…The prevalence of bonding disorders among healthy postpartum mothers is approximately 20%. 10,11 In fact, in a study by Brockington et al, 29% of the participating mothers with maternal postpartum depression were prospectively diagnosed with bonding disorders. 12 These disorders are characterized by the expression of limited levels of maternal affection (and affectionate behaviours) towards the child.…”

A Lateral Cephalographic Evaluation of Association of Cleft Lip and Palate With Cervical Vertebral Anomalies

“…[2] In addition, these children and their families often experience serious psychological problems. [3,4] With rapidly advancing knowledge in medical genetics and with new DNA diagnostic technologies, more cleft lip and palate anomalies are diagnosed antenatally and more orofacial clefts identified as syndromic. Although the basic rate of clefting (1:500 to 1:550) has not changed since Fogh-Andersen performed his pioneering 1942 genetic study distinguishing two basic categories of orofacial clefts-namely, CL with or without CP (CL/P) and CP alone [5] -these clefts can now be more accurately classified.…”