Objective: This study examines phenotypic presentation and perioperative outcomes of cleft-related procedures for infants with cleft lip and/or palate (CL/P) and prenatal opioid exposure.
Design: This is a retrospective review of infants with prenatal opioid exposure treated for CL/P from 2008 to 2018.
Setting: Patients cared for at a tertiary center from 2008 to 2018.
Patients/participants: Eighteen patients with documented prenatal opioid exposure and CL/P had primary repairs in our unit.
Main outcome measure(s): The phenotypes of CL/P were characterized. Demographic data regarding additional exposures, as well as associated medical and social comorbidities were recorded. Outcome variables included operative delays, perioperative complications, and loss of follow-up.
Results: Isolated cleft palate (CP; 67%) was overrepresented among patients with prenatal opioid exposure and CL/P, as was Robin sequence (50% in isolated CP). Fifty-six percent had exposure to additional substances. A majority (67%) had other medical conditions or anomalies, and 17% had known genetic syndromes. Seventy-two percent were in state custody. Thirty-nine percent of exposed patients had delays in their planned operative dates due to medical and/or social factors. There were no postoperative readmissions following cleft procedures. Lack of follow-up was noted in 33% of patients.
Conclusions: Infants with CL/P who have prenatal opioid exposure are likely to have additional medical conditions and complex social challenges.
Keywords: cleft lip and palate; neonatal abstinence syndrome; opioid exposure.