Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic
Article first published online: 22 JUN 2009
© 2009 The Author(s)/Journal Compilation © 2009 Foundation Acta Pædiatrica
Volume 98, Issue 9, pages 1494–1499, September 2009
How to Cite
Hutchison, B., Stewart, A. W. and Mitchell, E. A. (2009), Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic. Acta Paediatrica, 98: 1494–1499. doi: 10.1111/j.1651-2227.2009.01356.x
- Issue published online: 27 JUL 2009
- Article first published online: 22 JUN 2009
- Received 15 January 2009; revised 16 March 2009; accepted 27 April 2009.
- Deformational plagiocephaly;
- Infant care;
Aim: To describe the characteristics, developmental status and severity of head shape deformation in infants presenting to a plagiocephaly clinic.
Methods: Head shape was measured and neck function assessed in 287 consecutive infants presenting to a plagiocephaly outpatient clinic. Information was obtained on demographic and obstetric factors, plagiocephaly history and current positioning strategies. Development was assessed by the Ages and Stages Questionnaire (ASQ).
Results: After clinical examination, craniosynostosis was suspected in seven infants (2%) and a skull computed tomography (CT) scan was performed; five showed suture abnormalities. Fifty-eight percent of cases had a history of limitation of neck function; this was more likely in plagiocephalic infants than brachycephalic infants. Males, firstborn infants, instrument-delivered infants, supine sleep position and right-sided flattening were predominant. One or more delays on the ASQ were seen in 36% of infants.
Conclusion: Physical examination of infants with head shape deformities is essential in order to rule out craniosynostosis. Infants with deformational plagiocephaly frequently have neck muscle dysfunction. We postulate that the higher than expected number of developmental delays may be related to the effects of supine sleep position, low or variable tone, lower activity levels, male gender and neck muscle dysfunction.