The course of skull deformation from birth to 5 years of age: a prospective cohort study.
In a continuation of a prospective longitudinal cohort study in a healthy population on the course of skull shape from birth to 24 months, at 5 years of age, 248 children participated in a follow-up assessment using plagiocephalometry (ODDI-oblique diameter difference index, CPI-cranio proportional index). Data from the original study sampled at birth, 7 weeks, 6, 12, and 24 months were used in two linear mixed models.


RESULTS
(1) if deformational plagiocephaly (ODDI <104%) and/or positional preference at 7 weeks of age are absent, normal skull shape can be predicted at 5 years of age; (2) if positional preference occurs, ODDI is the highest at 7 weeks and decreases to a stable lowest value at 2 and 5 years of age; and (3) regarding brachycephaly, all children showed the highest CPI at 6 months of age with a gradual decrease over time.


CONCLUSIONS
The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, brachycephaly is within the normal range for all children, whereas the severity of plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate/severe range in 1%. Medical consumption may be reduced by providing early tailored counselling. What is Known: • Skull deformation prevalence increased after recommendations against Sudden Infant Death Syndrome, little is known about the longitudinal course. • Paediatric physical therapy intervention between 2 and 6 months of age reduces deformational plagiocephaly at 6 and 12 months of age. What is New: • The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, deformational brachycephaly is within the normal range for all children, whereas the severity of deformational plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate to severe range in only 1%. • Paediatric physical therapy intervention does not influence the long-term outcome; it only influences the earlier decrease of the severity of deformational plagiocephaly.
Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands. leo.vanvlimmeren@radboudumc.nl.|Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands. leo.vanvlimmeren@radboudumc.nl.
Leo A
LA
van Vlimmeren
ACHIEVE, Center of Applied Research, Faculty of Health, University of Applied Sciences, Tafelbergweg 51, 1000 CN, Amsterdam, The Netherlands.|Academic Medical Center, Department of Rehabilitation, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Raoul Hh
RH
Engelbert
Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands.|Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands.
Maaike
M
Pelsma
Department for Health Evidence, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands.
Hans Mm
HM
Groenewoud
Department Health Technology and Services Research, Institute for Governance Studies, University of Twente, P.O. 217, 7500 AE, Enschede, The Netherlands.
Magda M
MM
Boere-Boonekamp
Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands.|Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB, Nijmegen, The Netherlands.
Maria Wg Nijhuis-van
MW
der Sanden
D002675:Child, Preschool; D003398:Craniosynostoses / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D026741:Physical Therapy Modalities; D049068:Plagiocephaly, Nonsynostotic / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012886:Skull / Q000002:abnormalities*; D016683:Supine Position
Deformational brachycephaly; Deformational plagiocephaly; Newborns; Skull deformation