Quality of Life of Adopted Chinese Versus Nonadopted Dutch Children with Cleft Lip and/or Palate: A Propensity Score Matched Analysis.

Martinus M Van Veen,Chantal M Mouës-Vink,Bente A Van Den Berge

doi:10.1177/10556656211050795

Martinus M Van Veen, Chantal M Mouës-Vink + Show 1 more

Open Access

https://doi.org/10.1177/10556656211050795

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Abstract

ObjectiveTo examine quality of life in internationally adopted children with cleft lip and/or palate (CL/P) versus non-adopted children with CL/P.DesignCross sectional study.SettingMultidisciplinary cleft team of a secondary and tertiary hospital in the Netherlands.MethodsParents of children under the age of 8 treated by the multidisciplinary cleft team of our institutions were asked to fill out a questionnaire containing demographic and clinical data and a validated parent proxy measure of cleft-specific quality of life instrument for children aged 0–8: the CleftChild-8. Adopted children were matched to non-adopted children using propensity score matching based on sex, age, type of cleft, if palatal surgery was completed and the level of education of the parent. CleftChild-8 scores were then compared between the matched samples of adopted and non-adopted children with CL/P.Main Outcome Measure(s)Differences in (sub)domain scores of the CleftChild-8.ResultsMost median CleftChild-8 scores of the adopted children (n = 29) were slightly lower compared to the 29 matched non-adopted children. A significant difference was seen for the domain score ‘satisfaction with (operative) treatment’ and 3 of the 13 subdomain scores: ‘post-operative results’, ‘acceptance by siblings’ and ‘acceptance by family/friends’.ConclusionsBy parent report, adopted children with CL/P experienced some areas of lower quality of life when compared to non-adopted children. Members of cleft teams should be aware of the problems associated with adoption and offer additional guidance and counseling to adopted children and their parents.

Highlights

The number of internationally adopted children has been decreasing for years in most western countries including the Netherlands (Stichting Adoptievoorzieningen, 2017)
All children with cleft lip and/or palate (CL/P) treated by the multidisciplinary CL/P treatment teams of the Medical Center Leeuwarden and University Medical Center Groningen aged 8 years old or younger were initially eligible for participation
The propensity score matching procedure resulted in 29 pairs of participants (Figure 1)

Summary

Introduction

The number of internationally adopted children has been decreasing for years in most western countries including the Netherlands (Stichting Adoptievoorzieningen, 2017). The number of adopted children with congenital diagnoses, such as cleft lip and/or palate (CL/P), remains stable, and these children form a distinct treatment challenge for Dutch CL/P treatment teams. Adopted children often have complex medical needs, and may have an additional history of trauma, neglect and institutionalization (Knipper et al, 2020). Independent from adoptionrelated risk, any major medical experience can potentially lead to the development of post-traumatic stress in children (Scheeringa, 2019). Surgical care providers should be aware of the distinctive situation of internationally adopted children

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