Clinical StudiesThe Impact of Ethnicity on Craniosynostosis in the United StatesSacks, Gina N. MD*; Skolnick, Gary B. BS*; Trachtenberg, Ali BS§; Naidoo, Sybill D. PhD*; Lopez, Joseph MD†; Oh, Albert K. MD‡; Chao, Jerry W. MD‡; Dorafshar, Amir Mb, ChB†; Vercler, Christian J. MD§; Buchman, Steven R. MD§; Patel, Kamlesh MD, MSc*Author Information *Division of Plastic and Reconstructive Surgery, Washington University, St. Louis Children's Hospital, St. Louis, MO †Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD ‡Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington DC §Section of Plastic Surgery, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, MI. Address correspondence and reprint requests to Kamlesh Patel, MD, MSc, Washington University in Saint Louis, Plastic and Reconstructive Surgery, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110; E-mail: Kamlesh.Patel@wustl.edu Received 10 February, 2019 Accepted 17 August, 2019 Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) and Children's Discovery Institute. The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com). Journal of Craniofacial Surgery: November-December 2019 - Volume 30 - Issue 8 - p 2526-2529 doi: 10.1097/SCS.0000000000006009 Buy SDC Metrics Abstract While many studies have examined potential risk factors for nonsyndromic craniosynostosis, there have been no publications to date investigating the role of ethnicity in the United States. The current study was undertaken as the first multi-center investigation to examine the relationship between ethnicity and nonsyndromic craniosynostosis, looking at both overall prevalence as well as potential correlation between ethnicity and pattern of affected suture site. A chart review of patients diagnosed with nonsyndromic craniosynostosis treated at four major children's hospitals was performed to obtain ethnicity data. Analysis was preformed based on ethnic group as well as suture site affected. To account for potential One regional selection bias, the KID database (1997–2012) was utilized to identify all cases of craniosynostosis on a national level. This data was analyzed against birth rates by ethnicity obtained from CDC WONDER natality database. Amongst the 2112 cases of nonsyndromic craniosynostosis at all institutions, Caucasians and African Americans were consistently the predominant ethnic groups. There was a statistically significant difference in the distribution of affected suture type with African Americans more likely to present with unicoronal synostosis and Caucasians more likely to present with metopic synostosis (P = 0.005). The national data revealed that there were more cases of craniosynostosis in Caucasians and fewer in African Americans than expected when compared to population birth rates. Our findings demonstrate that the Caucasian race is associated with increased rates of synostosis. © 2019 by Mutaz B. Habal, MD.