Children's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California 90027, USA.
Am J Med Genet A. 2010 Feb;152A(2):394-400. doi: 10.1002/ajmg.a.33246.
Non-syndromic craniosynostosis is multifactorial, and fetal head constraint has been hypothesized as one factor thought to play a role. Data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, were used to evaluate associations between four selected factors related to fetal constraint and craniosynostosis: plurality (twins or higher), macrosomia (birth weight >4,000 g), post-term gestational age (> or =42 weeks), and nulliparity (no previous live births). Case infants (n = 675) had craniosynostosis documented either by radiographic evidence or by surgical intervention. Infants with a recognized or strongly suspected single-gene conditions or chromosomal abnormalities were excluded. Control infants (n = 5,958) had no major birth defects and were randomly selected from the same population as case infants. Logistic regression was used to estimate odds ratios for the association between these four factors and craniosynostosis, while adjusting for several covariates. We found that plurality and nulliparity were associated with a twofold increased risk for metopic craniosynostosis, and macrosomia had almost twice the risk of developing coronal craniosynostosis. Contrary to our hypothesis, prematurity and low birth weight were also associated with craniosynostosis. In conclusion, these four constraint-related factors were not found to be associated with craniosynostosis when all suture types were combined, though some types of craniosynostosis were associated with individual constraint-related factors.
非综合征性颅缝早闭是多因素的，胎儿头部受限被认为是其中一个起作用的因素。本研究使用了来自国家出生缺陷预防研究（NBDPS）的数据，该研究是一项大型多地点病例对照出生缺陷研究，用于评估与胎儿受限相关的四个选定因素（多胎妊娠[双胞胎或更高]、巨大儿[出生体重>4000g]、过期妊娠[>42 周]和初产妇[无活产分娩史]）与颅缝早闭之间的关系。病例婴儿（n=675）的颅缝早闭通过放射学证据或手术干预来确定。排除了具有已知或强烈怀疑的单基因疾病或染色体异常的婴儿。对照婴儿（n=5958）没有主要的出生缺陷，并且是从与病例婴儿相同的人群中随机选择的。使用逻辑回归来估计这四个因素与颅缝早闭之间的关联的优势比，同时调整了几个协变量。我们发现，多胎妊娠和初产妇与额缝早闭的风险增加两倍相关，而巨大儿发生冠状缝早闭的风险几乎增加了一倍。与我们的假设相反，早产和低出生体重也与颅缝早闭有关。总之，当所有的颅缝类型都合并时，这四个与限制相关的因素与颅缝早闭没有关联，尽管某些类型的颅缝早闭与个别与限制相关的因素有关。
