Risk factors associated with deformational plagiocephaly

The Cleft Palate-Craniofacial Journal, 2008

Objectives: To describe infant and maternal characteristics among infants with plagiocephaly and to quantify time trends in potential risk factors for plagiocephaly.

Plagiocephaly is defined as asymmetrical distortion of the skull resulting in an oblique trapezoid or parallelogram head shape. In the absence of skull growth restriction due to craniosynostosis, deformational plagiocephaly (DP) is caused by deformational forces acting on one side of the back of the head which distorts the normal symmetry of the skull. The aims of this systematic review and meta-analysis were to critically assess the evidence for non-obstetric risk factors for DP and to make evidence-based recommendations for reducing the prevalence of DP. A search of PubMed and Web of Science was performed covering 21 August 2010 to 21 August 2022. The searches yielded 159 articles, of which 18 articles were eligible for inclusion in this study. 43 non-obstetric factors were identified. Of these, a total of 17 factors were associated with DP. With the notable exceptions of maternal age, mechanical ventilation and tummy time, these associations were either supported by non-conflicti...

2014

Deformational plagiocephaly (DP) refers to asymmetry of the infant skull characterized by flattening or deformation. DP can include facial and neck asymmetry. Congenital muscular torticollis (CMT) is often involved and should be ruled out as a causative factor for DP. In contrast to craniosynostosis, which occurs when 1 or more cranial sutures are prematurely fused (stenosed), nonsynostotic DP is not related to bone/skull fusion. Craniosynostosis warrants surgical correction and therefore must also be ruled out as a causative factor for DP. Craniosynostosis may occur in conjunction with accompanying syndromes (eg, genetic or chromosomal disorders, spinal disease, etc.), and these conditions should be recognized early and monitored closely by a multidisciplinary healthcare team. This report will refer to nonsynostotic DP as DP and will review it. Craniosynostosis is not discussed in this report.

Paediatric and Perinatal Epidemiology, 2009

McKinney CM, Cunningham ML, Holt VL, Leroux B, Starr JR. A case-control study of infant, maternal and perinatal characteristics associated with deformational plagiocephaly. Paediatric and Perinatal Epidemiology 2009; 23: 332-345.

BMJ Paediatrics Open, 2021

Introduction Deformational plagiocephaly (DP) is one of the most common cranial shape disorders in infancy. It is characterised by unilateral flattening of the skull due to head preference to one side. The literature suggests that DP is associated with comorbidities such as developmental delay, but the nature and prevalence of the comorbid impairments are still unclear and controversial. Therefore, our scoping review (ScR) aims to explore systematically the extent and nature of literature by identifying, mapping and categorising the most relevant comorbidities of DP in children up to the age of 2 years. Methods and analysis This protocol is based on the framework outlined by Arksey and O’Malley. A systematic search will be conducted to identify relevant full text studies from 1992 to 2021 using the databases of Cochrane, MEDLINE, Google Scholar, EMBASE, PubMed and University of Nicosia EBSCO. Two independent reviewers will screen abstracts and full articles in parallel, using specif...

JPO Journal of Prosthetics and Orthotics, 2004

Compared with other topics in medicine, research on deformational plagiocephaly is relatively sparse. Among the published articles are a wide variety of studies ranging from simple case reports to well-designed cohort investigations. Unfortunately, variations in study design, methodology, sample size, and terminology often make it difficult to draw conclusions from this body of work.

PEDIATRICS, 2013

WHAT'S KNOWN ON THIS SUBJECT: Infants and toddlers with deformational plagiocephaly (DP) score lower on developmental measures than children without DP and lower than expected relative to test norms.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2017

Background: Deformational plagiocephaly (DP) refers to cranial asymmetry resulting from uneven external forces. A strong association exists between DP and developmental delay. We investigated the effect of DP severity on developmental delay. Methods: Between 2010 and 2016, data from 155 patients with DP were reviewed retrospectively. Two indices were used to evaluate the deformation quantitatively: cranial index (CI) and cranial vault asymmetry index (CVAI). The Bayley Scales of Infant Development-II was used to evaluate the neurodevelopment of patients. Results: According to the CI of the study population, 2 patients showed scaphocephaly, 12 showed mesocephaly, and 141 showed brachycephaly. For CVAI, 10 patients showed values of <3.5, 10 patients showed mild deformity (3.5e6.25), 27 patients showed moderate deformity (6.25e8.75), and 108 patients showed severe deformity. The means of the mental development index (MDI) and psychomotor development index (PDI) were 91.69 AE 16.8 and 92.28 AE 17.59, respectively; after the exclusion of patients with confounding factors, the values were 96.26 and 92.9, respectively. The Spearman correlation coefficients between MDI and CI and CVAI were À0.019662 and 0.118916, respectively, whereas for PDI, the values were À0.195428 and À0.012386, respectively. Conclusions: There was a statistically significant neurodevelopmental delay in patients with DP. However, accelerated neurodevelopment was also encountered in many patients. MDI was found to be more affected by multiple confounding factors than PDI, whereas PDI was only

Journal of Neurosurgery: Pediatrics, 2009

Object The increase in the prevalence of nonsynostotic occipital deformational plagiocephaly in infants, which resulted from the American Academy of Pediatrics&#39; 1992 recommendation to have healthy infants sleep supine, has been accompanied by significant controversy in diagnosis and management. The controversy was exacerbated by the 1998 FDA classification of cranial orthotic devices as Class II devices requiring premarket notification, and the subsequent increase in treatment-associated costs. Methods Two independent reviews of the literature were conducted to clarify the objective evidence available within the context of pediatric craniofacial knowledge. Results . Although deformational plagiocephaly is not a life-threatening problem, it is a source of disfigurement for children that may be detrimental to their well-being. Current methods for quantifying the degree of disfigurement have limited interrater reliability, and no prospective randomized controlled trials comparing t...

European journal of pediatrics, 2015

Deformational plagiocephaly (DP) occurs frequently in otherwise healthy infants. Many infants with DP undergo physiotherapy or helmet therapy, and ample treatment-related research is available. However, the possibility of preventing DP has been left with little attention. We sought to evaluate the effectiveness of intervention in the newborn&#39;s environment, positioning, and handling on the prevalence of DP at 3 months and to investigate the causal relationship between DP and cervical imbalance. We carried out a randomized controlled trial, with healthy newborns randomized into two groups at birth. All families received standard positioning instructions to prevent SIDS. Additionally, the intervention group received detailed instructions regarding the infant&#39;s environment, positioning, and handling, with the goal of creating a nonrestrictive environment that promotes spontaneous physical movement and symmetrical motor development. Two- and three-dimensional photogrammetry serve...