MATERNAL EXPOSURE TO PRESCRIPTION AND NON PRESCRIPTION PHARMACEUTICALS OR DRUGS OF ABUSE AND RISK OF CRANIOSYNOSTOSIS

Background The pre-and peri-natal drug exposures reported by women par ticipating in a case-control study of children in Colorado were examin ed for association with infant craniosynostosis. Methods Mothers of ca se and control children underwent a standardized telephone interview a nd obstetric and newborn medical record review. The interview included questions on the use of prescription and non-prescription drugs, nutr itional supplements, recreational and drugs of abuse. The mother's obs tetric record was abstracted for information about pharmacologic agent s taken before and during the antepartum period. Reults There were no statistically significant risk ratios associating craniosynostosis wit h prenatal exposure to hydantoin, valproic acid, or cocaine. Mothers o f four case children and one control child reported specific exposure to retinoic acid. There were no statisically significant increases in the odds ratio (OR) for any suture type among children exposed to hypo xigenic agents, sympathomimetic or parasympatholytic agents, or metal- containing agents. The OR was 1.87 (lower bound of the two-sided 95% t est-based confidence interval (CI): 1.08) among children with sagittal /lambdoid suture synostosis who were exposed to nitrosatable drugs chl orpheniramine, chlordiazepoxide, and nitrofurantoin compared to contro ls. Conclusions Certain nitrosatable drugs may be associated with incr eased risk of infant sagittal/lambdoid craniosynostosis. A possible me chanism related to ischaemia/reperfusion injury is suggested.