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How Environment Shapes Development: A Prospective Study Examining the Influence of Neighborhood-Level Disadvantage on Brain and Language Development in Children with Cleft Lip and Palate
Tobi J. Somorin, BS1, Jesse A. Goldstein, MD1, Amy L. Conrad, PhD2
1. University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
2. University of I
2025-01-09
Presenter: Tobi J. Somorin
Affidavit:
The entirety of this abstract submission is the original work of the research team.
Director Name: Jesse A. Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Maternal stress, tobacco exposure, and poor oxygen quality are considered etiological factors in patients with cleft lip and/or palate (CL/P). Neighborhood-level disadvantage (NLD) may influence the development of CL/P and affect brain and language development. Our study examines how NLD impacts oxygen saturation, family stress, and brain and language development in children with CL/P.
Methods This prospective case-control study was conducted at two high-volume pediatric academic medical centers. We evaluated adaptive functioning, language, overnight pulse oximetry, and structural brain MRI in children with CL/P and unaffected controls at 2 months of age. Area Deprivation Index (ADI) was calculated using patient zip codes (higher ADI represents increasing NLD). Pearson correlations evaluated potential associations between ADI, SES, birthweight, family stress, language function, SpO2 saturation, and brain structure.
Results: We enrolled 20 participants (10 controls, 6 CL/P). Patients with CL/P had lower SES compared to controls (54.60 vs. 44.72, p=0.014). ADI was not significantly associated with SES, birthweight, or family stress, but higher ADI was correlated with poorer receptive language (r=-.434, p=.056). ADI showed no association with SpO2 levels or brain structure measures.
Conclusions: Our findings reinforce the well-established principle associating CL/P with lower socioeconomic status. NLD was linked to poor receptive language, potentially due to limited educational resources in disadvantaged areas. ADI was interestingly not correlated to SES or family stress, which may be the result of decreased power. Our results highlight the need for further educational resources for patients with CL/P living in socially disadvantaged communities.
