Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic.
OBJECTIVE
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.


CONCLUSIONS
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.
Hutchison
B L
BL
Department of Paediatrics, University of Auckland, Auckland, New Zealand. bl.hutchison@auckland.ac.nz
Stewart
Alistair W
AW
Mitchell
Edwin A
EA
D000554:Ambulatory Care Facilities; D002508:Cephalometry; D003393:Cranial Sutures / Q000002:abnormalities / Q000000981:diagnostic imaging; D003398:Craniosynostoses / Q000175:diagnosis*; D002658:Developmental Disabilities / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009334:Neck Muscles / Q000503:physiopathology*; D049068:Plagiocephaly, Nonsynostotic / Q000175:diagnosis*; D012307:Risk Factors; D012737:Sex Factors; D012886:Skull / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016683:Supine Position; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed