Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years.
OBJECTIVE
To compare head shape measurements, parental concern about head shape and developmental delays in infancy with measurements obtained at follow-up at ages 3 and 4 years.


METHODS
Longitudinal cohort study.


METHODS
Initial assessments were conducted at a plagiocephaly clinic; follow-up assessments were conducted in the children's homes.


METHODS
129 children with a mean age of 4 years (range 3 years 3 months to 4 years 9 months), all of whom were diagnosed in infancy with deformational plagiocephaly or brachycephaly.


METHODS
Head shape measurements of cephalic index and oblique cranial length ratio; level of parental concern about head shape; and delays on parent-completed age-appropriate Ages and Stages Questionnaires.


RESULTS
61% of head shape measurements reverted to the normal range; 4% remained severe at follow-up. Brachycephaly improved more than plagiocephaly. Facial and frontal asymmetry reduced to almost nil. Most had good improvement, but 13% were categorised as having 'poor improvement'. Initially, 85% of parents reported being 'somewhat' or 'very' concerned; this decreased to 13% at follow-up. The percentage of children with ≥1 delay decreased from 41% initially to 11% at follow-up.


CONCLUSIONS
Overall, head shape measurements, parental concern and developmental delays in infancy showed a dramatic improvement when re-measured at 3 and 4 years of age.
Hutchison
B L
BL
Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand. bl.hutchison@auckland.ac.nz
Stewart
A W
AW
Mitchell
E A
EA
D001007:Anxiety; D001294:Attitude to Health; D002508:Cephalometry; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006257:Head / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology*; D049068:Plagiocephaly, Nonsynostotic / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D011379:Prognosis; D011594:Psychometrics