Analysis of cranial type characteristics in term infants: a multi-center study

Abstract

Background Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard. Methods Overall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution. Results According to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively. Conclusions According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.

A comparative study between traditional head measurement and structured light three-dimensional scanning when measuring infant head shape

“…Head-shape problems are common among newborns and young children. Foreign studies have reported that the incidence of plagiocephaly in infants is 8.2-46.6% (1-3), while the incidence of head problems in 4,456 fullterm infants of 0-6 months in a Chinese study was about 56.5% (4). These findings suggest that the incidence of head problems in infants is common in the first few months after birth, and different races, regions, and cultures experience different cranial development.…”

“…In this formula, α=0.05/2, β=0.1, δ is the allowable error, and σ is the standard deviation. Based on data acquired in our previous studies (4), in terms of cranial vault asymmetry index (CVAI), the mean difference between the spreading caliper and 3D measurements was approximately 0.57 mm, and the standard deviation was approximately 2.42 mm. According to literature reports (6), the allowable error is 1 mm, the confidence level is 1−x =0.95, the power of a test (1−β) was 0.9, and the number of samples required was 64.…”

Research into the correlation between positional skull deformation and motor performance of infants aged under 4 months

“…Diagnostic criteria were based on the recommended diagnostic criteria of positional skull deformation in infants aged 0 to 6 months in Chongqing area [ 18 ]. Infants of different ages were grouped according to different types and degrees of PD (Table 1 ).…”

Revisiting the Cephalic Index: The Origin, Purpose, and Current Applicability—A Narrative Review

“…It is important for clinicians to note the specific landmarks and clinical techniques (e.g., manual or scanned) used by various researchers to obtain and report on cephalic width and length measurements. For example, anterior landmarks reported in various publications include the nasion, [22][23][24] glabella, 1,9,11,12,[19][20][21][25][26][27] or other (e.g., not specified, 2 cm above the nasion, middle of the nose, maximum length of the measurement plane, subnasal, sellion, nose tip, occipitofrontal diameter). 26,[28][29][30][31][32][33][34][35][36] Posterior landmarks may be the opisthocranion, 1,9,11,12,20,21,24,26,27 inion, 23 occipital protuberance, 19,22,25,30 or other (e.g., not specified, most projecting point at the back of the head, maximum length of measurement plane, occiput, greatest cranial length).…”

“…For example, anterior landmarks reported in various publications include the nasion, [22][23][24] glabella, 1,9,11,12,[19][20][21][25][26][27] or other (e.g., not specified, 2 cm above the nasion, middle of the nose, maximum length of the measurement plane, subnasal, sellion, nose tip, occipitofrontal diameter). 26,[28][29][30][31][32][33][34][35][36] Posterior landmarks may be the opisthocranion, 1,9,11,12,20,21,24,26,27 inion, 23 occipital protuberance, 19,22,25,30 or other (e.g., not specified, most projecting point at the back of the head, maximum length of measurement plane, occiput, greatest cranial length). 19,25,28,29,[33][34][35][37][38][39] Lateral skull landmarks are the most varied and include the eurion, 12,24 bipari...…”