Socioeconomic Status and Cleft Lip and Palate in Thailand: A Review of Risk Factors and Public Health Implications

Authors

  • Siriporn Sasakul Faculty of Dentistry, Nation University

Keywords:

Cleft Lip and Palate, Socioeconomic Status, Risk Factors, Public Health, Cleft Lip and Palate, Socioeconomic Status, Risk Factors, Public Health, Thailand

Abstract

             Cleft Lip and Palate (CLP) is a prevalent craniofacial condition that significantly impacts health, quality of life, and psychosocial well-being (Hodges et al., 2022). While genetic factors play a major role, recent research highlights the strong influence of socioeconomic status (SES) on CLP prevalence and severity (Beaty et al., 2016; Jindal et al., 2018). This review examines the link between SES and CLP in Thailand, emphasizing key risk factors and public health implications.

            Studies indicate that lower SES is associated with increased risk due to maternal malnutrition (Sivertsen et al., 2020), inadequate prenatal care, exposure to environmental toxins (Shaw et al., 2019), and limited access to healthcare services (WHO, 2021). Public health policies, such as folic acid fortification programs, have been shown to reduce the incidence of congenital anomalies, including CLP (Parker et al., 2023; Wilcox et al., 2019). Addressing these disparities through targeted interventions and improved healthcare access is crucial for mitigating the prevalence and severity of CLP in Thailand.

References

Beaty, T. H., Marazita, M. L., & Leslie, E. J. (2016). Genetic factors influencing risk to orofacial clefts: Today's challenges and tomorrow's opportunities. F1000Research, 5, 2800. https://doi.org/10.12688/f1000research.9503.1

Dixon, T. A., Cohen, E., Cairns, D. M., Rodriguez, M., Mathews, J., Jose, R. R., & Kaplan, D. L. (2018). Bioinspired three-dimensional human neuromuscular junction development in suspended hydrogel arrays. Tissue Engineering Part C: Methods, 24(6), 346–359. https://doi.org/10.1089/ten.tec.2017.0532

Hodges, A., Steinbacher, D. M., & O’Brien, K. (2022). Long-term psychosocial impact of cleft lip and palate: A review of patient outcomes. Journal of Craniofacial Surgery, 33(5), 1201–1208. https://doi.org/10.1097/SCS.0000000000008324

Jindal, A., Khan, M. A., & Shah, S. A. (2018). The impact of socioeconomic status on cleft lip and palate treatment outcomes: A systematic review. Plastic and Reconstructive Surgery, 142(2), 256–265. https://doi.org/10.1097/PRS.0000000000004642

Mossey, P. A., Little, J., Munger, R. G., Dixon, M. J., & Shaw, W. C. (2020). Cleft lip and palate. The Lancet, 374(9703), 1773–1785. https://doi.org/10.1016/S0140-6736(09)60695-4

Parker, S. E., Mai, C. T., Strickland, M. J., Meyer, R. E., Canfield, M. A., & Correa, A. (2023). The impact of public health policies on reducing congenital anomalies: Evidence from folic acid fortification programs. American Journal of Public Health, 113(1), 50–59. https://doi.org/10.2105/AJPH.2022.306095

Rahimov, F., Marazita, M. L., Visel, A., Cooper, M. E., Hitchler, M. J., & Rubini, M. (2019). Disruption of the IRF6 gene regulatory network as a potential cause of cleft lip and palate. American Journal of Human Genetics, 104(5), 918–926. https://doi.org/10.1016/j.ajhg.2019.03.011

Shaw, G. M., Carmichael, S. L., Yang, W., Harris, J. A., Finnell, R. H., & Lammer, E. J. (2019). Environmental and genetic factors influencing the risk of orofacial clefts. Birth Defects Research, 111(14), 745–758. https://doi.org/10.1002/bdr2.1529

Shkoukani, M. A., Chen, M., & Vong, A. (2013). Cleft lip – A comprehensive review. Frontiers in Pediatrics, 1, 53. https://doi.org/10.3389/fped.2013.00053

Sivertsen, Å., Wilcox, A. J., Skjaerven, R., Vindenes, H. A., Lie, R. T., & Åbyholm, F. (2020). The role of maternal nutrition in the prevention of orofacial clefts: A systematic review. European Journal of Clinical Nutrition, 74(8), 1120–1132. https://doi.org/10.1038/s41430-020-0587-9

Watkins, S. E., Meyer, R. E., Strauss, R. P., & Aylsworth, A. S. (2014). Classification, epidemiology, and genetics of orofacial clefts. Clinics in Plastic Surgery, 41(2), 149–163. https://doi.org/10.1016/j.cps.2013.12.003

Wattanawongwan, S., Smith, S. D., & Vannest, K. J. (2021). Cooperative learning strategies for building relationship skills in students with emotional and behavioral disorders. Beyond Behavior, 30(1), 4–13. https://doi.org/10.1177/1074295621997599

Wehby, G. L., Dave, D. M., & Kaestner, R. (2020). Effects of the minimum wage on infant health. Journal of Policy Analysis and Management, 39(2), 411–443. https://doi.org/10.1002/pam.22218

Wilcox, A. J., Lie, R. T., & Solvoll, K. (2019). Folic acid supplements and risk of facial clefts: A national population-based study. BMJ, 318(7181), 84–87. https://doi.org/10.1136/bmj.318.7181.84

World Health Organization. (2021). Addressing inequalities in access to cleft lip and palate treatment worldwide. https://www.who.int/publications

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Published

2025-12-15

How to Cite

Sasakul , S. . (2025). Socioeconomic Status and Cleft Lip and Palate in Thailand: A Review of Risk Factors and Public Health Implications. Thai Journal of Public Health and Health Sciences, 8(3), 110–121. retrieved from https://he02.tci-thaijo.org/index.php/tjph/article/view/274313

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Section

Research Articles