Searching for a link between cleft lip and palate and stress

Around the world, between about one and two babies in every 1000 are born each year with either a cleft lip or cleft palate, or both. A Southern Cross University researcher has set out to investigate the possible causes of these conditions.

He is seeking pregnant women residing anywhere between the Sunshine Coast and Melbourne to participate in his research.

Nutritionist and PhD candidate Graeme Wallace is investigating a new theory linking cleft lip and palate disorders with nutritional deficiencies caused by any kind of stress shortly before or during the early stages of pregnancy.

He first saw a possible correlation while working in the Philippines – a country with one of the highest incidences of these disorders.

Mr Wallace visited the Philippines at the start of his research project as part of an Australian surgical mission to help youngsters suffering from cleft lip and palate disorders.

Doctors working in the Philippine hospital indicated that they thought clefting was a problem of the poor, suggesting to him that nutrition and environment may play a key role in causing such anomalies. Also, the link between low socioeconomic status and stress has been well documented.

“Initially this research project aimed to consider the possibility of other causal factors of these disorders, such as alcohol and drug use, or a mother’s smoking habits if any, and nutritional supplementation taken prior to and during the pregnancy,” Mr Wallace said.

“However, even at an early stage in the study, stress seemed to be a possible issue of relevance and this led to us considering other work that had already been done linking clefting to stress.”

Mr Wallace found, for instance, that studies in both Czechoslovakia and Iraq had found a strong correlation between cleft lip and palate disorders and the stress levels of pregnant women.

“Stress, be it physical (such as from injury or nutrient deficiencies) or emotional, will lead to changes in the body’s internal functioning. This physiological process is also known as ‘oxidative stress’,” he said.

“We know that stress levels affect the metabolism and thus the environment in which cells reproduce and develop. If stress levels are low or of short duration, physiology and cell development and replication can return to normal, while continuously high stress levels lead to possible abnormal development or cell death.

“The development and function of foetal tissue and organs is directly proportional to the amount of blood they receive. A hormonal response of a mother experiencing stress will profoundly alter the distribution of blood flow in her foetus and change the character of her developing child’s physiology.

“While a mother may in fact be healthy in herself, increased stress in her body could possibly lead to nutritional deficiencies occurring in the foetus at a particular time in its development.”

Mr Wallace first conducted an Australian study into clefting in 2007-2008. Families who had a child two years or younger with a cleft were included in the study. Nearly three quarters of mothers reported high stress levels before or during pregnancy, he said.

In this new study, Mr Wallace is seeking 50 pregnant women who have been diagnosed as carrying a foetus with a cleft who would like to participate in his research project. He is also seeking 50 pregnant women who are not carrying a foetus with a known cleft anomaly, for comparison.
Participants will be required to complete a questionnaire and provide a blood and urine sample, to assess their nutritional status. A hair sample will be analysed for mineral deficiencies and the presence of heavy metals.

“We will be looking for any correlation between nutritional status and oxidative stress in the mother with clefting in the child,” Mr Wallace said.

Contact will continue to be made with the women over the course of the pregnancy, directly and via the national support group, CleftPALS – a great resource for any parent with a child with a clefting problem.

The research project is being partly funded through a grant of $80,000 from Healthscope, a leading Australian private pathology laboratory.

For more information or to register your interest in participating in the project, please contact Graeme Wallace on 0418 248 983 or email him at: graemew@bigpond.net.au. He is seeking pregnant women residing anywhere between the Sunshine Coast and Melbourne to participate in his research.

Photo: Graeme Wallace is seeking 100 pregnant women to participate in his research on cleft lip and palate disorders.