title: First-trimester nonsystemic corticosteroid use and the risk of oral clefts in Norway.
abstract: OBJECTIVE
  Exposure of pregnant mice to corticosteroids can produce oral clefts in offspring. Although data in humans are more mixed, recent reports have suggested that dermatologic steroids are associated with oral clefts.
  
  
  METHODS
  We investigated maternal first-trimester exposure to corticosteroids (focusing on dermatologic uses) and oral clefts in offspring using two population-based studies. The Norway Cleft Study (1996-2001) is a national case-control study including 377 infants with cleft lip ± palate (CLP), 196 infants with cleft palate only (CPO), and 763 controls. The Norwegian Mother and Child Cohort Study (MoBa, 1998-2008) is a national birth cohort including 123 infants with CLP, 61 infants with CPO, and 551 controls.
  
  
  RESULTS
  In the case-control study, there was the suggestion of an association of dermatologic corticosteroids with both CLP (adjusted OR [aOR], 2.3; 95% confidence interval [CI], 0.71-7.7) and CPO (aOR, 3.4; CI, 0.87-13). There was no evidence of this association in the cohort data (odds ratio for CLP, 1.2; CI, 0.50-2.8 and odds ratio for CPO, 1.0; CI, 0.30-3.4), although exposure to dermatologic steroids was less specifically ascertained. There were no associations with other types of corticosteroids.
  
  
  CONCLUSIONS
  Our data add to the suggestive but inconsistent findings for this association.
authors.affiliation: Department of Plastic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Electronic address: hildur.skuladottir@gmail.com.
authors.forename: Hildur
authors.initials: H
authors.lastname: Skuladottir
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC.
authors.forename: Allen
authors.initials: A
authors.lastname: Wilcox
authors.affiliation: WESTAT, Epidemiology Branch, Durham, NC.
authors.forename: Robert
authors.initials: R
authors.lastname: McConnaughey
authors.affiliation: Department of Plastic Surgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: Hallvard
authors.initials: H
authors.lastname: Vindenes
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Rolv T
authors.initials: RT
authors.lastname: Lie
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D002971:Cleft Lip / Q000139:chemically induced* / Q000453:epidemiology; D002972:Cleft Palate / Q000139:chemically induced* / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents
keywords: Cleft lip; Cleft palate; Corticosteroids; Maternal exposure; Moba; Pregnancy