Cleft Palate Analysis

According to the CDC (Centers for Disease Control and Prevention) cleft lip and cleft palate in newborns occurs early during pregnancy when the baby’s lips and palates do not properly form together causing a separation or opening around the lips and under the roof of the mouth (CDC, 2014). Most commonly referred to as “orofacial clefts”, a baby can either have a cleft lip, cleft palate, or a combination of both a cleft lip and palate (CDC, 2014). Birth defects such as “orofacial clefts” are among one of the most common of all birth defects affecting approximately 1 to 2 out of every 1,000 babies that are born in the United States each year (Kids Health, 2014). An estimate of around 2,650 babies are born with a cleft palate and 4440 babies are born with a cleft lip with or without a cleft palate every year in the United States (CDC, 2014). Worldwide figures illustrates approximately 1 out of every 700 babies is born with craniofacial anomalies making the prevalence of cleft lip and cleft palate even greater outside of the United States (Murray, 2002).

Formation of Cleft Lip or Palate
A cleft lip can occur between weeks 4-7 during pregnancy when tissue that makes up the lips do not fully come together causing an opening that can range from a small slit or a large opening that goes from the lip into the nasal cavity (CDC, 2014).

A cleft palate occurs between weeks 6-9 of the pregnancy when the roof of the mouth does not properly form together (CDC,

2014).
Causes
The occurrences of birth defects resulting in cleft lip or cleft palates are thought to originate from a combination of factors that include genetic factors (inherited from parents) and environmental factors (consumption of medications or lack of vitamins) (Kids Health, 2014). Certain ethnic groups have a higher prevalence of the birth defect. For example, Native American, Asian, and Latino babies have a higher chance of being born with cleft lips or palates than other ethnic groups, while babies with African descent have the least chance of cleft births (Kids Health, 2014). Important findings in research studies points to certain factors that may add to increased risk of having a child with an orofacial cleft. For instance, women who smoke while being pregnant will be more likely to have a child with a cleft than women who do not smoke. Furthermore, women who are diagnosed with diabetes before pregnancy have a higher risk of having a child with a cleft than women who are not diabetic before pregnancy. Additionally, women who take epilepsy medication, such as valrproic acid or topiramate during the first 3 months of pregnancy will have a higher chance of having a child with a cleft than women not taking the medication. Data collected from animal models suggests that there are four genes in which gene expressions supports their role in orofacial cleft development: Msx1, Tgfb3, Tfap2a, and Gabrb3. Msx1 develops craniofacial structures. Tgfb3 results in the phenotype of having a cleft palate. Tfap2a results in other craniofacial and structural issues. Gabrb3 may have role in human clefting.