The Influence of Race and Socioeconomic Status on Growth in Children Who Undergo Palatoplasty.

Abstract

This study aims to explore whether racial identity or socioeconomic status (SES) is associated with growth trajectory before and after palatoplasty. This study was a single-site retrospective chart review at a tertiary pediatric hospital. This study involved children with cleft palate repaired between 2006 and 2022. Primary outcomes were changes in growth trajectories before and after palatoplasty stratified by race and median neighborhood income (MNI) as a measure of SES. In the data query, 187 and 149 patients met the inclusion criteria for the racial identity and MNI analyses, respectively. The median pre- and post-surgical weekly weight gain was 0.11 kg/wk. and 0.05 kg/wk. for patients who are BIPOC (Black, Indigenous, and People of Color) (p = < 0.0001), and 0.12 and 0.07 kg/wk. for patients who are White (p = < 0.0001). Change in median growth percentile following palatoplasty was significant for patients who are White but was not significant for patients who are BIPOC. MNI displayed a significant relationship with weekly weight gain and growth percentile changes following palatoplasty. Patient racial identity is associated with clinically meaningful differences in growth trajectory outcomes following palatoplasty. While growth outcomes may differ across MNI, living in areas with higher MNI does not directly translate to improved growth trajectories following palatoplasty. Addressing all social determinants of health in this population is critical, but interventions should focus on supporting racial minorities as they experience the most significant disparities.