Occurrence of craniosynostosis in neonates exposed to cocaine and tobacco in utero.

The occurrence of craniosynostosis (premature closure of cranial sutures) has been reported to be 3 to 5 per 10,000 live births. The incidence is even lower among African-American infants. The District of Columbia General Hospital serves primarily the African-American population with approximately 2000 deliveries a year. In the last 10 years, three neonates with craniosynostosis have been born at DC General Hospital; all three infants were African Americans. These infants were exposed to cocaine and tobacco in utero, which suggests a possible association between intrauterine cocaine and tobacco exposure and premature closure of cranial sutures. Possible pathogenesis of craniosynostosis in association with cocaine and tobacco use is discussed.