Risk factors for positional plagiocephaly and appropriate time frames for prevention messaging.
OBJECTIVE
To determine potential risk factors for developing positional plagiocephaly in infants seven to 12 weeks of age in Calgary, Alberta.


METHODS
A prospective cohort design was used. Healthy term infants (n=440), seven to 12 weeks of age, from well-child clinics at four community health centres in Calgary, Alberta were assessed by the primary author and a registered nurse research assistant using Argenta's plagiocephaly assessment tool. Parents completed a questionnaire surveying risk factors.


RESULTS
The incidence of positional plagiocephaly was estimated to be 46.6%. The following risk factors were identified using multiple logistic regression: right-sided head positional preference (OR 4.66 [95% CI 2.85 to 7.58]; P<0.001), left-sided head positional preference (OR 4.21 [95% CI 2.45 to 7.25]; P<0.001), supine sleep position (OR 2.67 [95% CI 1.58 to 4.51]; P<0.001), vacuum/forceps assisted delivery (OR 1.88 [95% CI 1.02 to 3.49]; P=0.04) and male sex (OR 1.55 [95% CI 1.00 to 2.38]; P=0.05).


CONCLUSIONS
Advice to vary infants' head positions needs to be communicated to parents/guardians well before the two-month well-child clinic visit. This could occur in the prenatal period by prenatal care providers or educators, or during the neonatal period by postpartum and public health nurses. Prevention education may be emphasized for parents/guardians of male infants and infants who have had assisted deliveries.
School of Nursing, Faculty of Health and Community Studies, Mount Royal University;
Aliyah
A
Mawji
Department of Community Health Sciences, Faculty of Medicine, University of Calgary;
Ardene Robinson
AR
Vollman
Information Technologies, University of Calgary;
Tak
T
Fung
Department of Community Health Sciences, Faculty of Medicine, University of Calgary;
Jennifer
J
Hatfield
Faculty of Nursing, University of Calgary; ; Population and Public Health, Alberta Health Services;
Deborah A
DA
McNeil
Department of Community Health Sciences, Faculty of Medicine, University of Calgary; ; Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta.
Reginald
R
Sauvé
Deformational plagiocephaly; Nonsynostotic plagiocephaly; Positional plagiocephaly; Prevention; Risk factors