title: Dolichocephaly in Preterm Infants: Prevalence, Risk Factors, and Early Motor Outcomes.
abstract: ObjectiveThe purpose of this study was to determine when dolichocephaly develops in preterm infants, to establish factors that contribute to its development, and to determine its association with adverse motor outcomes.Study DesignThis study was a retrospective review of data collected from preterm infants born at < 32 weeks' gestation. The cranial index was measured by a physical therapist (PT) at three time points during hospitalization. Demographic data, neonatal morbidities, and motor outcomes at outpatient follow-up were collected.ResultsOverall, 54% of infants developed dolichocephaly during hospitalization. The presence of dolichocephaly was highest in infants between 32 and 34 weeks' postmenstrual age (PMA) (39%). Birth weight, gestational age, bronchopulmonary dysplasia, gastroesophageal reflux disease, and severe intraventricular hemorrhage were not associated with dolichocephaly. Infants with dolichocephaly at 32 to 34 weeks' PMA were more likely to either be receiving PT services or be referred to PT services by outpatient follow-up (p= 0.05).ConclusionThe presence of dolichocephaly was highest in infants between 32 and 34 weeks' PMA and was associated with increased need for PT services in early infancy. Findings support early developmental intervention at < 32 weeks' PMA to prevent and/or treat cranial molding deformity and improve early motor outcomes.
authors: Division of Physical Therapy, Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Dana B
authors: DB
authors: McCarty
authors: Department of Physical and Occupational Therapy, Duke University Medical Center, Durham, North Carolina.
authors: Jennifer R
authors: JR
authors: Peat
authors: Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors: William F
authors: WF
authors: Malcolm
authors: Department of Pediatrics, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina.
authors: P Brian
authors: PB
authors: Smith
authors: Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors: Kimberley
authors: K
authors: Fisher
authors: Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors: Ricki F
authors: RF
authors: Goldstein
mesh_terms: D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D019957:Motor Skills Disorders / Q000209:etiology / Q000628:therapy*; D056888:Patient Positioning / Q000009:adverse effects*; D026741:Physical Therapy Modalities; D049068:Plagiocephaly, Nonsynostotic / Q000209:etiology* / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors