Kruppa, KaylaKruger, EsedraVorster, CarlienVan der Linde, Jeannie2023-03-242023-03-242022-05Kruppa, K., Krüger, E., Vorster, C. & Van der Linde, J. Cleft Lip and/or Palate and Associated Risks in Lower-Middle-Income Countries: A Systematic Review. The Cleft Palate Craniofacial Journal. 2022; 59(5): 568-576. doi: 10.1177/10556656211018952.1055-6656 (print)1545-1569 (online)10.1177/10556656211018952http://hdl.handle.net/2263/90202OBJECTIVE : To identify and review published data on the risks associated with cleft lip and/or palate (CL/P) in lower-middle-income countries (LMICs). DESIGN : A systematic review of literature was performed on electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Literature on risks associated with CL/P in LMICs, from 2010 to 2020, were included. RESULTS : Seventeen studies met the inclusion criteria. All studies adopted an observational study design. Biological and environmental risks were identified. Maternal and paternal age (n = 7) and low socioeconomic status (n = 5) were the most prominently associated environmental risk factors. A strong association was identified between family history of cleft (n = 7) and CL/P occurrence. CONCLUSION : Environmental risk factors are now being investigated more than biological risk factors in LMICs, aiding health care workers in the early identification of possible cumulative effects of risks in CL/P. Contextually relevant tools are recommended to promote early identification of at-risk infants.en© 2021, American Cleft Palate-Craniofacial AssociationCleft lip and/or palate (CL/P)Low- and middle-income countries (LMICs)Biological risksEnvironmental risksSystematic reviewPostprint Article