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© 1998 Oxford University Press

research-article

Maternal exposure to prescription and non-prescription pharmaceuticals or drugs of abuse and risk of craniosynostosis

Jacqueline S Gardnera, Beatrice Guyard-Boileaub, Beth W Aldermanc, Sandra K Fernbachd, Carol Greenee and Ellen J Mangionef

aDepartment of Pharmacy Box 357630, University of Washington, Seattle, WA 98195, USA
bHôpital Saint Antoine Paris, France
cDepartment of Epidemiology, University of Washington Seattle, WA, USA
dDepartment of Radiology, Children's Memorial Hospital Chicago, IL. USA
eDepanment of Pediatrirs, University of Colorado Health Sciences Center and the Children's Hospital Denver, CO. USA
fDisease Control and Environmental Epidemiology Division, Colorado Depanment of Health Denver, CO. USA

BACKGROUND: The pre- and pen-natal drug exposures reported by women participating in a case-control study of children in Colorado were examined for association withinfant craniosynostosis.

METHODS: Mothers of case and control children underwent a standardized telephone interview and obstetric and newborn medical record review. The interview included questions on the use of prescription and non-prescription drugs, nutritional supplements, recreational and drugs of abuse. The mother's obstetric record was abstracted for information about pharmacologic agents taken before and during the antepartum period.

RESULTS: There were no statistically significant risk ratios associating craniosynostosis with prenatal exposure to hydantoin, vaiproic acid, or cocaine. Mothers of four case children and one control child reported specific exposure to retinoic acid. There were no statisicafly significant increases in the odds ratio (OR) for any suture type among children exposed to hypoxigenic agents, sympathomimetic or parasympatholytic agents, or metal-containing agents. The OR was 1.87 (lower bound of the two-sided 95% test-based confidence interval (CI) : 1.08) among children with sagittal/lambdoid suture synostosis who were exposed to nitro satable drugs chiorpheniramine, chlordiazepoxide, and nitrofurantoin compared to controls.

CONCLUSIONS: Certain nitrosatable drugs may be associated with increased risk of infant sagittal/lambdoid craniosynostosis. A possible mechanism related to ischaernia/ reperfusion injury is suggested.

Keywords craniosynostosis, nitrosatable drugs, pharmacoepidemiology, maternal exposure

Accepted 1 April 1997


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