Influência da Fissura Labiopalatina no Desenvolvimento Motor em Crianças na Região Oeste do Paraná - Brasil

Abstract

Cleft lip and palate (CLP) is the most prevalent congenital craniofacial anomaly worldwide; its correction must begin early and requires multiple procedures and prolonged treatment periods, often leading to various complications that may affect infant motor development (MD). Since the literature on this topic is still incipient, this research was conducted in two stages. The first consisted of an integrative review to identify a possible relationship between CLP and delays in MD, and the second investigated the impact of this condition on the motor performance of infants up to 18 months of age. For the review, primary and secondary studies published between 1990 and 2020 were analyzed with no language restrictions. Of the 360 articles extracted using defined criteria from relevant databases, 8 studies were included. The results indicate significant delays in children with CLP, especially in language and fine motor skills, as well as impairments in cognitive, social, and personal domains. The severity and anatomical type of the cleft appeared to be potential modulators of the profile and intensity of delays, although this association was not consistently observed across studies. The observational research with a cross sectional design was conducted at a specialized craniofacial anomaly center in a public hospital in the western macroregion of Paraná, Brazil. Data collection took place between 2020 and 2025, during which 204 infants were assessed, and the type of cleft was classified using the Spina scale, and MD was measured using the Alberta Infant Motor Scale (AIMS). Analyses were performed in R software (version 4.5.1), and homogeneity between categories was assessed using Pearson’s chi square test. Differences in performance between postures in each trimester were analyzed using one-way ANOVA, followed by Tukey’s test (p < 0.05). The results showed that most children with clefts were male (53,4%), with an equivalent distribution among cleft types (pre-foramen 33,3%, , post-foramen 31.0%, trans foramen 37.1%) and a predominance of unilateral clefts (56.0%). It was found that 50.2% of the children scored below the 50th percentile on the AIMS, indicating risk or clear motor delay. The analysis revealed that the supine posture showed early stabilization, whereas the other postures exhibited gradual progression and greater variability, reflecting an increase in biomechanical complexity and postural control demands. Moreover, the study validates the use of the AIMS for this population, providing a useful tool to quantify deficits and support early interventions aimed at ensuring the full motor development of children with clefts.