Causes Of Cleft Palate & Lip

Cleft lip and palate is a birth defect in which, during development of the embryo, the roof of the mouth, also called the palate, and the lip do not fuse together properly. Facial clefting is one of the most common birth defects and occurs once in every 500 to 590 births. A facial cleft may involve just the lip, just the palate or both.

Maternal Smoking

Smoking during pregnancy is associated with an increased risk of having a child with cleft palate or cleft lip. According to the journal Epidemiology, smoking during pregnancy is associated with a 20 percent increased risk of cleft lip or palate in the child. Not smoking and avoiding secondhand smoke exposure during pregnancy reduces, but does not eliminate, the risk to have a child affected with cleft lip and palate.

Nutrition and Medications

Good nutrition in pregnancy is thought to be protective against cleft palate and lip. The use of prenatal multivitamins is associated with a 25 percent decrease in the incidence of clefting, according to the Lancet. Zinc, folate and vitamin B6 are thought to be the more important vitamins and minerals that seem to have a protective effect against cleft lip and palate. Conversely, being deficient in these essential vitamins and minerals during pregnancy increases the risk.

In addition, certain drugs have been associated with facial clefts. Medications taken during pregnancy should be discussed with a doctor to ensure they are safe or that the benefits of the drug outweigh potential dangers.

Familial Genetic Factors

Various genes have been identified as having a causal role in the development of cleft lip or palate. However, these genes are called “complex traits,” meaning that both genetics and environment play a role in the development of a facial cleft. In general, a parent who was born with an isolated cleft lip and palate has a higher chance of having a child with cleft lip and palate than the general population. This is the same for a family who has already had a child with a facial cleft. Speaking with a genetic counselor can help families determine their chances for having a child with this type of birth defect.

Genetic Syndromes

Facial clefting is associated with more than 200 genetic syndromes. Many of these syndromes occur sporadically, meaning they do not have a family history, but others are inherited genetic syndromes. These syndromes can have a variety of different associated features, such as other birth defects and learning and cognitive problems, among others. They range in severity from mild to very severe. An evaluation by a medical geneticist can identify a genetic syndrome that may be present in an individual with a cleft lip or cleft palate.