Maternal thyroid disease as a risk factor for craniosynostosis.
OBJECTIVE
To study the relationship between maternal thyroid disease and craniosynostosis using data from the National Birth Defects Prevention Study, a multisite, case-control study.


METHODS
Case infants (n=431) were identified through population-based birth defects surveillance systems at eight sites and had craniosynostosis verified by radiographic imaging. Control infants (n=4,094) consisted of a random sample of live births with no major birth defects from the same population as the case infants. Information on thyroid disease was based on self-report: mothers who reported either a thyroid disorder or use of a medication to treat a thyroid disorder during pregnancy were considered to have thyroid disease. Using an unconditional logistic regression model, we considered potential confounding factors (maternal age, race or ethnicity, smoking, body mass index, preexisting diabetes, plurality, gravidity, family history, infant sex).


RESULTS
Among case mothers, 19 (4.4%) were classified as having thyroid disease, compared with 65 (1.6%) of control mothers. Maternal thyroid disease was associated with craniosynostosis after controlling for maternal age (adjusted odds ratio 2.47, 95% confidence interval 1.46-4.18), the only factor that remained significant in the final model.


CONCLUSIONS
These data provide additional evidence that maternal thyroid disease (most likely Graves' disease) or its treatment is associated with craniosynostosis. Given the frequency of maternal thyroid disease, this association warrants further investigation.


METHODS
II.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA. skr9@cdc.gov
Sonja A
SA
Rasmussen
Mahsa M
MM
Yazdy
Suzan L
SL
Carmichael
Denise J
DJ
Jamieson
Mark A
MA
Canfield
Margaret A
MA
Honein
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003398:Craniosynostoses / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D013959:Thyroid Diseases / Q000150:complications* / Q000188:drug therapy; D014481:United States / Q000453:epidemiology