title: Clinical course of asymmetric motor performance and deformational plagiocephaly in very preterm infants.
abstract: OBJECTIVE
  To describe the clinical courses of positional preference and deformational plagiocephaly up to 6 months corrected age (CA) in infants born at gestational age <30 weeks or birth weight <1000 g, and to explore predictive factors for the persistence of these phenomena.
  
  
  METHODS
  A total of 120 infants were examined 3 times each. The presence of deformational plagiocephaly and a score of 0-6 on an asymmetry performance scale served as outcome measures at 6 months CA. Predictive factors were determined using regression analysis.
  
  
  RESULTS
  The prevalence of a positional preference of the head was 65.8% (79 of 120) at term-equivalent age (TEA) and 36.7% (44 of 120) at 3 months CA and that of deformational plagiocephaly was 30% (36 of 120) at TEA and 50% (60 of 120) at 3 months CA. At 6 months CA, 15.8% of the infants (19 of 120) scored ≥ 2 of a possible 6 on the asymmetry performance scale and 23.3% (28 of 120) had deformational plagiocephaly. Sleeping in the supine position was predictive of an asymmetric motor performance at 6 months CA. Chronic lung disease and/or slow gross motor maturation at 3 months CA predicted the persistence of deformational plagiocephaly.
  
  
  CONCLUSIONS
  Infants born very preterm may develop deformational plagiocephaly. A positional preference of the head at TEA seems to be a normal aspect of these infants' motor repertoire, with limited ability to predict persistence of an asymmetric motor performance. The decreased prevalence of deformational plagiocephaly between 3 and 6 months CA indicates an optimistic course. Infants with a history of chronic lung disease and/or slow gross motor maturation merit timely intervention.
authors.affiliation: Child Development and Exercise Center, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. j.nuysink@umcutrecht.nl
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Nuysink
authors.forename: Maria J C
authors.initials: MJ
authors.lastname: Eijsermans
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: van Haastert
authors.forename: Corine
authors.initials: C
authors.lastname: Koopman-Esseboom
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Janjaap
authors.initials: J
authors.lastname: van der Net
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D015999:Multivariate Analysis; D049068:Plagiocephaly, Nonsynostotic / Q000209:etiology / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D012890:Sleep
keywords: AIMS; Alberta Infant Motor Scale; BW; Birth weight; CA; Corrected age; GA; Gestational age; T1; T2; T3; TEA; TIMP; TIMP Screening Instrument; TIMPSI; Term-equivalent age; Test of Infant Motor Performance; Time 1; Time 2; Time 3