Approach to the Prevention of Orofacial Cleft

In the area of vitamins, research results over the last several years have indicated that the B-vitamin folic acid has been shown to prevent some, but not all, cases of spina bifida and other neural tube defects. Evidence is growing that vitamins may play an important role in the etiology of other birth defects.

The Director of ODS participated in a workshop, Approach to the Prevention of Orofacial Cleft, March 16-18, 1996 held in San Francisco, California with the Director, National Institute of Dental Research (NIDR), that was co-sponsored by the March of Dimes Foundation, California Birth Defects Monitoring Program, and the Centers for Disease Control and Prevention, to evaluate these recent research findings and discuss future research possibilities. This first meeting focused on the potential role for ingestion of periconceptual folic acid supplements to reduce the risk of cleft lip with or without cleft palate.

In the US the incidence of neural tube defects has been estimated at 4,000 each year, whereas the incidence of cleft lip with or without cleft palate has been estimated at 1 in every 700 live births. While cleft lip and cleft palate birth defects can be surgically repaired, the estimated cost per child for the series of operations is $100,000. These costs do not begin to account for the stress and emotional strain on the child and parents.

In addition, it is estimated that there is a 31.4 percent relative risk of recurrence of cleft lip with or without cleft palate in families with an affected child. Clearly, reduction of occurrence or recurrence of this birth defect would have major public health benefit. Additional meetings are planned to further review the literature and plan possible joint activities.