{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:43:20Z","timestamp":1788284600641,"version":"build-2803163510"},"reference-count":67,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examined the association between maternal pharmacological exposures and nonsyndromic craniosynostosis (NSC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      Design and\n                      <jats:italic toggle=\"yes\">M<\/jats:italic>\n                      ethods\n                    <\/jats:title>\n                    <jats:p>In this retrospective database study, all pregnancies affected by NSC were identified in the Epic Cosmos database and matched 1:1 to control pregnancies for case-control analysis. In hypothesis-driven analysis, associations between NSC and first- or second-trimester medication exposures with prior evidence of association were estimated. In exploratory analysis, all first- and second-trimester medication exposures were compared, and those that remained significant after correction for multiple comparisons with an odds ratio &gt;2 were retained. All significant exposures were reevaluated in sibling-controlled models to isolate within-family risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>10,470 pregnancies affected by NSC and 10,470 control pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      Main\n                      <jats:italic toggle=\"yes\">O<\/jats:italic>\n                      utcome\n                      <jats:italic toggle=\"yes\">M<\/jats:italic>\n                      easure\n                    <\/jats:title>\n                    <jats:p>Adjusted odds ratios (aORs) estimating the association between candidate medication exposures and NSC in case-control analysis; within-family risk of NSC in sibling-controlled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among medications with prior evidence, exogenous thyroid hormones (aOR: 1.25 [95% CI: 1.07, 1.47]) and selective serotonin reuptake inhibitors (SSRIs) (aOR: 1.31 [95% CI: 1.17, 1.46]) were significantly associated with NSC. Exploratory analysis revealed topiramate (aOR: 2.29 [95% CI: 1.50, 3.49]) and hydroxychloroquine (aOR: 5.42 [95% CI: 2.08, 14.12]) as significant. However, in sibling-controlled analysis, only topiramate remained significantly associated with NSC (aOR: 1.42 [95% CI: 1.10, 1.81]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings identify topiramate as a potential teratogen for craniosynostosis. The modest association and null sibling effect for SSRIs do not support discontinuation during pregnancy. Associations with thyroid hormones suggest a complex interplay between thyroid function and suture development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261465182","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:59:52Z","timestamp":1783335592000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prescription Drug Exposures During Pregnancy and Risk of Nonsyndromic Craniosynostosis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7630-9992","authenticated-orcid":false,"given":"Samira","family":"Glaeser-Khan","sequence":"first","affiliation":[{"name":"Yale School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Kong","sequence":"additional","affiliation":[{"name":"Yale School of 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