Risk factors associated with positional plagiocephaly in healthy Iranian infants: a case-control study
Iranian Journal of Child Neurology,
Vol. 16 No. 2 (2022),
14 Esfand 2022
,
Page 85-92
https://doi.org/10.22037/ijcn.v16i1.28524
Abstract
Abstract
Objectives
Deformation of the skull by external forces in the absence of synostosis has been defined as positional plagiocephaly. The aim of this investigation was to determine the risk factors of positional plagiocephaly (PP) in healthy Iranian infants.
Materials & Methods
This case-control study was performed on 300 healthy Iranian infants aged 8-12 weeks who referred to pediatric neurology clinic at Shahid Beheshti Hospital of Kashan. Plagiocephaly evaluations were done by using Argenta’s scale.
Results
Based on multivariate logistic regression analysis, there was significant association between PP and male gender (OR=2.26; P=0.002), head circumference (OR=1.22; P=0.006), multiple pregnancy (OR=2.55; P=0.03), abnormal presentation in uterine (OR=2.18; P=0.02), primiparity (OR=2.43; P=0.003), and supine sleep position (OR=2.97; P<0.001). But type of delivery, firmness of headrest, oligohydramnios, and prolonged labor were not correlated with PP.
Conclusions
The current investigation supports the idea that head circumference, male gender, primiparity, multiple pregnancy, supine sleep position, and abnormal presentation in uterine are correlated with a greater incidence of PP. Further investigations should be undertaken to fully understand PP and its related risk factors.
- Positional plagiocephaly
- infants
- risk factor
How to Cite
References
De Bock F, Braun V, Renz-Polster H. Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses. Arch Dis Child. 2017;102:535-42.
Laughlin J, Luerssen TG, Dias MS. Prevention and management of positional skull deformities in infants. Pediatrics. 2011;128:1236-41.
Bialocerkowski AE, Vladusic SL, Wei Ng C. Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Dev Med Child Neurol. 2008;50:577-86.
van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, et al. Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: a prospective cohort study. Pediatrics. 2007;119:e408-18.
Hutchison BL, Stewart AW, Mitchell EA. Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic. Acta Paediatr. 2009;98:1494-9.
Rogers GF. Deformational plagiocephaly, brachycephaly, and scaphocephaly. Part I: terminology, diagnosis, and etiopathogenesis. J Craniofac Surg. 2011;22:9-16.
Looman WS, Flannery AB. Evidence-based care of the child with deformational plagiocephaly, Part I: assessment and diagnosis. J Pediatr Health Care. 2012;26:242-50; quiz 51-3.
Pogliani L, Mameli C, Fabiano V, et al. Positional plagiocephaly: what the pediatrician needs to know. A review. Childs Nerv Syst. 2011;27:1867-76.
Hutchison BL, Stewart AW, Mitchell EA. Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. Arch Dis Child. 2011;96:85-90.
Martiniuk AL, Vujovich-Dunn C, Park M, et al. Plagiocephaly and Developmental Delay: A Systematic Review. J Dev Behav Pediatr. 2017;38:67-78.
Fontana SC, Daniels D, Greaves T, et al. Assessment of Deformational Plagiocephaly Severity and Neonatal Developmental Delay. J Craniofac Surg. 2016;27:1934-6.
Aarnivala H, Vuollo V, Harila V, et al. Preventing deformational plagiocephaly through parent guidance: a randomized, controlled trial. Eur J Pediatr. 2015;174:1197-208.
Argenta L, David L, Thompson J. Clinical classification of positional plagiocephaly. J Craniofac Surg. 2004;15:368-72.
Pritchard J, MacDonald P, Gant N. Williams obstetrics 17th ed. Norwalk Appleton Century Crafts. 1985:525-60.
DeGrazia M, Giambanco D, Hamn G, Ditzel A, Tucker L, Gauvreau K. Prevention of
deformational plagiocephaly in hospitalized infants using a new orthotic device. J Obstet Gynecol Neonatal Nurs. 2015 Jan- Feb;44(1):28-41
Littlefield TR, Kelly KM, Pomatto JK, et al. Multiple-birth infants at higher risk for development of deformational plagiocephaly: II. is one twin at greater risk? Pediatrics. 2002;109:19-25.
Kane AA, Mitchell LE, Craven KP, et al. Observations on a recent increase in plagiocephaly without synostosis. Pediatrics. 1996;97:877-85.
Gardner J, Lewkowicz D, Turkewitz G. Development of postural asymmetry in premature human infants. Dev Psychobiol. 1977;10:471-80.
Joganic JL, Lynch JM, Littlefield TR, et al. Risk factors associated with deformational plagiocephaly. Pediatrics. 2009;124:e1126-33.
Oudgenoeg-Paz O, Mulder H, Jongmans MJ, et al. The link between motor and cognitive development in children born preterm and/or with low birth weight: A review of current evidence. Neurosci Biobehav Rev. 2017;80:382-93.
Hutchison BL, Thompson JM, Mitchell EA. Determinants of nonsynostotic plagiocephaly: a case-control study. Pediatrics. 2003;112:e316.
Clarren SK. Plagiocephaly and torticollis: etiology, natural history, and helmet treatment. J Pediatr. 1981;98:92-5.
Littlefield TR, Kelly KM, Pomatto JK, et al. Multiple-birth infants at higher risk for development of deformational plagiocephaly. Pediatrics. 1999;103:565-9.
Petricelli CD, Resende AP, Elito Junior J, et al. Distensibility and strength of the pelvic floor muscles of women in the third trimester of pregnancy. Biomed Res Int. 2014;2014:437867.
Michel GF, Goodwin R. Intrauterine birth position predicts newborn supine head position preferences. Infant behavior and Development. 1979;2:29-38.
Dunn PM. Congenital postural deformities. Br Med Bull. 1976;32:71-6.
Oh AK, Hoy EA, Rogers GF. Predictors of severity in deformational plagiocephaly. J Craniofac Surg. 2009;20 Suppl 1:685-9.
McKinney CM, Cunningham ML, Holt VL, et al. Characteristics of 2733 cases diagnosed with deformational plagiocephaly and changes in risk factors over time. Cleft Palate Craniofac J. 2008;45:208-16.
Mawji A, Vollman AR, Fung T, et al. Risk factors for positional plagiocephaly and appropriate time frames for prevention messaging. Paediatr Child Health. 2014;19:423-7.
Bridges SJ, Chambers TL, Pople IK. Plagiocephaly and head binding. Arch Dis Child. 2002;86:144-5.
Graham JM, Jr., Gomez M, Halberg A, et al. Management of deformational plagiocephaly: repositioning versus orthotic therapy. J Pediatr. 2005;146:258-62.
Peitsch WK, Keefer CH, LaBrie RA, et al. Incidence of cranial asymmetry in healthy newborns. Pediatrics. 2002;110:e72.
Losee JE, Mason AC, Dudas J, et al. Nonsynostotic occipital plagiocephaly: factors impacting onset, treatment, and outcomes. Plast Reconstr Surg. 2007;119:1866-73.
Stein RA. Smith's recognizable patterns of human malformation, 6th edition. Arch Dis Child. 2007;92(6):562.
Mulliken JB, Vander DW, Hansen M, et al. Analysis of posterior plagiocephaly: deformational versus synostotic. Plastic and reconstructive surgery. 1999;103:371-80.
Glasgow TS, Siddiqi F, Hoff C, et al. Deformational plagiocephaly: development of an objective measure and determination of its prevalence in primary care. J Craniofac Surg. 2007;18:85-92.
Seoane S, Zagalsky P, Borao D, et al. Plagiocefalia postural y craneoestenosis: factores asociados y evolución. Archivos argentinos de pediatría. 2006;104:501-5.
Hutchison BL, Hutchison LA, Thompson JM, et al. Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics. 2004;114:970-80.
Boere-Boonekamp MM, van der Linden-Kuiper LL. Positional preference: prevalence in infants and follow-up after two years. Pediatrics. 2001;107:339-43.
Davis BE, Moon RY, Sachs HC, et al. Effects of sleep position on infant motor development. Pediatrics. 1998;102:1135-40.
McKinney CM, Cunningham ML, Holt VL, et al. A case-control study of infant, maternal and perinatal characteristics associated with deformational plagiocephaly. Paediatr Perinat Epidemiol. 2009;23:332-45.
Dewey C, Fleming P, Golding J. Does the supine sleeping position have any adverse effects on the child? II. Development in the first 18 months. ALSPAC Study Team. Pediatrics. 1998;101:E5.
New joint statement on SIDS and safe sleep. Paediatr Child Health. 2011;16(8):461. doi:10.1093/pch/16.8.461
Ballardini E, Sisti M, Basaglia N, et al. Prevalence and characteristics of positional plagiocephaly in healthy full-term infants at 8-12 weeks of life. Eur J Pediatr. 2018;177:1547-54.
Moon RY. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics. 2016;138.
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