Micronutrient intake and food insecurity among mothers of infants with orofacial clefts: a cross-sectional study in Iran

Cleft lip with or without cleft palate is a common congenital craniofacial anomaly influenced by genetic and environmental factors. This cross-sectional study investigated maternal micronutrient intake and household food insecurity among Iranian mothers of infants with orofacial clefts. Mothers of infants aged 0–12 months with cleft lip (CL), cleft palate (CP), or both were recruited from a referral hospital in Tehran (2019–2020). Dietary intake was assessed using a validated food frequency questionnaire, and food security was evaluated with a standardized instrument. Multinomial logistic regression was performed to examine associations. High prevalences of inadequate intake were observed for iron (91.0%), vitamin D (73.6%), vitamin A (70.6%), folate (60.2%), calcium (56.7%), and vitamin B6 (50.7%). Vitamin B12 inadequacy differed significantly across cleft types (p = 0.023), with higher prevalence in CP (35.8%) and CL/P (38.6%) compared with CL (19.2%). Food insecurity also differed significantly by cleft type (p = 0.024), with hunger reported in 42.9% of the CL/P, 24.5% of the CP, and 20.5% of the CL groups. In multinomial logistic regression (reference: CL), food insecurity without hunger was associated with lower odds of CL/P in the crude model (OR = 0.30, 95% CI: 0.14–0.65), although this association was attenuated after adjustment. However, a significant trend between increasing food insecurity and cleft severity persisted across all models (P-trend = 0.028). These findings highlight the importance of maternal nutrition and food security in preventive strategies.