Microcytic Anaemia Among Patients with Cleft Lip with or without Palate: A Single Center Five-Year Experience in Bangladesh.

Cleft lip with or without palate (CL/P) is the commonest craniofacial anomaly found across the world. Prevalence of anaemia among cleft patients varies from as high as 83.1% to 39.4% among various studies, but there is a ubiquitous predominance of microcytic anaemia among them. Objective of the study was to know the prevalence of microcytic anaemia among CL/P patients, evaluate the association of microcytic anaemia with gender, urbanization, consanguinity of marriage, type of cleft and association with other anomalies, as well as its impact on perioperative cleft care. This was a retrospective cross-sectional analysis of data collected from the Comprehensive Cleft Care Centre, Bangladesh (2016-2020). Data of patients with non-syndromic CL/P aged up to 5 years were included, excluding craniofacial and syndromic clefts. After determining the prevalance of microcytic anaemia among population, demographic and available clinical findings were compared between microcytic anaemia and non-microcytic anaemia group. Among 387 cases, 111 cases (28.7%) had microcytic anaemia. Microcytic anaemia was found to be more prevalent among males (64.0%) than females (36.0%). Both urban (27.0%) and rural (30.0%) babies with CL/P had similar prevalances of microcytic anaemia. Only 18.2% cleft babies of consanguineous parents had microcytic anaemia. Microcytic anaemia was found to be most prevalent among babies with cleft lip only (46.8%). Microcytic anaemia in CL/P babies was not found to be significantly associated with other congenital anomalies, but it had an odds ratio of 1.6. Sixteen (16) cases had to be delayed in surgery due to anaemia, among which 87.4% had microcytic anaemia. Microcytic anaemia was found to be significantly associated with perioperative blood transfusion. Few babies with microcytic anaemia (6.3%) had post-operative wound dehiscence. Timely blood film analysis, early iron supplementation and perioperative anaemia optimization can make comprehensive cleft care more successful.