In-vitro fertilisation as an independent risk factor for bilateral cleft lip and palate: A multicentre clinical and maxillofacial analysis

Abstract

Objective: To determine whether in-vitro fertilisation (IVF) is associated with increased rates and severity of cleft lip and/or palate (CLP), and to identify associated maxillofacial and perinatal factors

Methods: A retrospective multicentre clinical study was done using 250 children with cleft lip, cleft palate and combined cleft lip and palate, who received treatment in maxillofacial surgery centres. Out of them, 80 children were conceived by IVF, and 170 were conceived naturally. The medical records gathered data on clinical characteristics such as cleft type, maxillofacial features, maternal age, birth weight and pregnancy-related factors. The chi-square and independent t-tests were used to compare statistical differences across groups. The multivariate logistic regression analysis was used to determine the independent predictors of bilateral cleft lip and palate.

Results: Children conceived through IVF had significantly higher rates of bilateral CLP compared to naturally conceived children (25% vs. 11.8%, p=0.02). The IVF group also showed more severe maxillary involvement, including wider alveolar clefts (47.5% vs. 30.6%, p=0.03) and greater maxillary hypoplasia (37.5% vs. 22.4%, p=0.02). IVF remained an independent risk factor for bilateral CLP after multivariate analysis (adjusted OR 2.4, 95% CI 1.1-5.1, p=0.03).

Conclusion

IVF conception is associated with more severe, bilateral forms of CLP, independent of maternal and perinatal factors. These findings support enhanced prenatal counselling and multidisciplinary planning for families undergoing IVF.