INCREASED RISK OF CRANIOSYNOSTOSIS WITH MATERNAL CIGARETTE-SMOKING DURING PREGNANCY

We analyzed data from a population-based case control study to determi ne whether maternal prenatal smoking or alcohol drinking might increas e the risk of craniosynostosis. Between 1986 and 1989, the Colorado Cr aniosynostosis Registry ascertained 233 children whose diagnoses were confirmed by an independent radiologist. Of the 212 (91%) cases who pa rticipated, 86 had lambdoid, 69 had sagittal, 25 had coronal, 18 had m etopic, and 14 had multiple suture synostosis. Random sampling of birt h certificate records yielded 367 eligible controls, of whom 291 (79%) participated. Study staff interviewed case and control mothers betwee n 1989 and 1991 for prenatal smoking and alcohol drinking. We used Man tel-Haenszel and polychotomous logistic regression techniques to estim ate the relative odds of craniosynostosis for smoking and drinking in all cases and in relevant case subgroups. Smoking was associated with a relative odds of craniosynostosis of 1.7 (95% confidence interval, 1 .2-2.6). For smoking of more than one pack per day, the relative odds were 3.5 (1.5-8.4) for all types of synostosis combined, and 5.6 (2.1- 15.3) for coronal synostosis. No strong or significant association was noted for drinking. Maternal prenatal smoking may increase the risk o f craniosynostosis in This population. (C) 1994 Wiley-Liss, Inc.