title: Cleft lip with or without cleft palate: effect of family history on reproductive planning, surgical timing, and parental stress.
abstract: OBJECTIVE
  This study tested whether the presence of a family history of nonsyndromic cleft lip with or without cleft palate (NSCLP) lessens the negative impact on reproductive planning, decreases treatment anxiety, and relieves parental stress when there is a recurrent cleft.
  
  
  METHODS
  Sixty-one participating families, retrospectively ascertained through their children with NSCLP, were divided into two groups: those with a family history of clefting and those in which only the proband was affected.
  
  
  METHODS
  Each family completed a questionnaire either at their home or during a clinic visit.
  
  
  METHODS
  Questionnaires were distributed to 117 families with an NSCLP child. Of these 117, 49 (42%) had another family member with NSCLP and 68 (58%) had no prior history of clefting. Sixty-one (52%) families returned the questionnaire and were categorized by family history.
  
  
  METHODS
  The Parenting Stress Index and the Hollingshead Index of Social Position were included with family and medical history questions in the 137-item questionnaire.
  
  
  RESULTS
  The reproductive plans of the two groups were quite similar and were not dependent on the families' actual or perceived recurrence risks of NSCLP. The majority (85%) of the children with NSCLP underwent surgical closure at the recommended age. The two groups did not significantly differ on any score on the Parenting Stress Index, indicating a similar parental stress level between the groups.
  
  
  CONCLUSIONS
  These findings suggest that family history does not significantly influence reproductive plans, timing of cleft repair, or stress of parents of a child with NSCLP. Further, these results indicate a need for additional psychosocial study of this population.
authors.affiliation: University of Texas Medical School at Houston, 77225, USA.
authors.forename: M
authors.initials: M
authors.lastname: Andrews-Casal
authors.forename: D
authors.initials: D
authors.lastname: Johnston
authors.forename: J
authors.initials: J
authors.lastname: Fletcher
authors.forename: J B
authors.initials: JB
authors.lastname: Mulliken
authors.forename: S
authors.initials: S
authors.lastname: Stal
authors.forename: J T
authors.initials: JT
authors.lastname: Hecht
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001007:Anxiety / Q000517:prevention & control; D001294:Attitude to Health; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000235:genetics* / Q000601:surgery; D002972:Cleft Palate / Q000235:genetics* / Q000601:surgery; D005192:Family Health; D005193:Family Planning Services; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012923:Social Class; D013312:Stress, Physiological / Q000209:etiology* / Q000517:prevention & control; D013315:Stress, Psychological / Q000209:etiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires