Corticosteroid use and risk of orofacial clefts.
BACKGROUND
Maternal use of corticosteroids during early pregnancy has been inconsistently associated with orofacial clefts in the offspring. A previous report from the National Birth Defect Prevention Study (NBDPS), using data from 1997 to 2002, found an association with cleft lip and palate (odds ratio, 1.7; 95% confidence interval [CI], 1.1-2.6), but not cleft palate only (odds ratio, 0.5, 95%CI, 0.2-1.3). From 2003 to 2009, the study population more than doubled in size, and our objective was to assess this association in the more recent data.


METHODS
The NBDPS is an ongoing multi-state population-based case-control study of birth defects, with ascertainment of cases and controls born since 1997. We assessed the association of corticosteroids and orofacial clefts using data from 2372 cleft cases and 5922 controls born from 2003 to 2009. Maternal corticosteroid exposure was based on telephone interviews.


RESULTS
The overall association of corticosteroids and cleft lip and palate in the new data was 1.0 (95% CI, 0.7-1.4). There was little evidence of associations between specific corticosteroid components or timing and clefts.


CONCLUSIONS
In contrast to the 1997 to 2002 data from the NBDPS, the 2003 to 2009 data show no association between maternal corticosteroid use and cleft lip and palate in the offspring.
Department of Plastic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway.
Hildur
H
Skuladottir
Allen J
AJ
Wilcox
Chen
C
Ma
Edward J
EJ
Lammer
Sonja A
SA
Rasmussen
Martha M
MM
Werler
Gary M
GM
Shaw
Suzan L
SL
Carmichael
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D044383:Black People; D016022:Case-Control Studies; D002971:Cleft Lip / Q000453:epidemiology* / Q000208:ethnology; D002972:Cleft Palate / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
D000305:Adrenal Cortex Hormones
birth defects; cleft lip and palate; corticosteroids; orofacial clefts; pregnancy