Parental Factors related to Development of Non-Syndromic Craniosynostosis in their Children

Abstract Purpose: There are case reports on potential parental risk factors regarding children with non-syndromic craniosynostosis implicating multiple possible pathologic contributions. A case control study was undertaken to elucidate any underlying trends of parental risk factors which yield craniosynostosis in their offspring. Methods: An IRB approved case-control study was performed by administering a survey to parents of children with and without craniosynostosis at the Children’s Hospital of Richmond from March 2018 to December 2019. To determine important risk factors for craniosynostosis, a classification and regression tree (CART) algorithm was employed. Results: Survey responses for 128 children were obtained, 78 (60.93%) of which had craniosynostosis. The remaining 50 children served as the control group. The classification tree produced splits based on the following five predictors: prematurity of the child, gender of the child, educational status of the mother, mother’s history of smoking and maternal diabetes. The most important factor was preterm birth of the infant. The second factor was the gender of the child followed by educational level and history of smoking, and finally presence of diabetes in the mother. The resulting classification tree was 78.9% accurate with high sensitivity (81.1%) and specificity (78.0%).Conclusion: Potential important predictors for craniosynostosis were identified through the classification tree including prematurity, sex of the child, maternal education level, maternal smoking status, and maternal diabetes status. These findings may help guide future research efforts into the pathophysiology of non-syndromic craniosynostosis.