Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses

Bock, Freia De; Braun, Volker; Renz‐Polster, Herbert

doi:10.1136/archdischild-2016-312018

Cited by 66 publications

(49 citation statements)

References 33 publications

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“…In previous studies, a significant neurodevelopmental delay was observed in children with deformational plagiocephaly, although no definitive relationship between the severity of deformation and the degree of developmental delay was found (the psychomotor development index was only affected by congenital anomalies) [41]. On the other hand, a systematic review showed a positive association between plagiocephaly and developmental delay in 13 of 19 studies, including four of five studies with a "strong" methodological quality [27].…”

Section: Discussionmentioning

confidence: 93%

“…The risk factors most frequently reported in the etiology of plagiocephaly are male gender, a supine sleep position, limited neck rotation or preference in head position, being firstborn, a lower level of activity, and a lack of tummy time [41]. Studies reporting the possible etiologies of plagiocephaly have analyzed a wide range of environmental and biological factors but have included few suggestions on the potential influence of everyday baby care environments [41]. The concordance between these studies is very poor for most exposures.…”

Section: Discussionmentioning

confidence: 99%

“…Some recent studies have indicated that pediatricians frequently face positional plagiocephaly associated with a supine sleeping position, head position preference, and an older maternal age [2,21,42]. There is a need to prevent both sudden infant death syndrome and positional plagiocephaly by providing small suggestions to influence the everyday care environment of infants through messages to parents, prenatally and postnatally, by different health professionals [21,41]. One review suggests that plagiocephaly is a marker of elevated risk of developmental delays and that clinicians should closely monitor infants with plagiocephaly for this marker.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Study of Cranial Deformity and Delayed Development in Children

et al. 2020

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Plagiocephaly, the most common form of cranial deformity, has become more prevalent in recent years. Many authors have described a number of sequelae of poorly defined etiologies, although several gaps exist in their real scope. This study aimed to analyze the effects of physiotherapy treatments and cranial orthoses on the psychomotor development of infants with cranial deformities, complemented by protocolized postural exercises applied by the family. This prospective study on different developmental areas included a sample of 48 breastfeeding infants aged 6 to 18 months who presented with plagiocephaly (flat head syndrome). The Brunet–Lézine scale was used to perform three tests for assessing the psychomotor development of infants, thus offering a measure for global development. The results suggest that plagiocephaly is a marker for the risk of delayed development, particularly in motor and language areas. This delayed development could be improved with physiotherapy and orthopedic treatment, complemented by interventions by the infants´ relatives.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Prospective Study of Cranial Deformity and Delayed Development in Children

et al. 2020

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“…In a Canadian cohort study, an estimated 47% of infants had some degree of NSP at 7–12 weeks of age (Mawji, Vollman, Hatfield, McNeil, & Sauve, ). The most commonly reported risk factors are firstborn, male, limited neck rotation or preference in head position, supine sleep position, lower level of activity and lack of tummy time (De Bock, Braun, & Renz‐Polster, ). The prevalence seems to peak at 4 months and then decreases as infants grow older (Hutchison, Hutchison, Thompson, & Mitchell, ).…”

Section: Introductionmentioning

confidence: 99%

Integrating new knowledge into practice: An evaluation study on a continuing education for Swedish child health nurses on non‐synostotic plagiocephaly

2018

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AimThe aim of this study was to assess what knowledge on non‐synostotic plagiocephaly prevention and reversal intervention and control group nurses imparted to parents and parents integrated in infant care.DesignA group of nurses participated in a continuing education on non‐synostotic plagiocephaly in one‐to‐one or small group sessions at their workplace and received guidelines to follow. An evaluation was conducted with 35 intervention group and 15 control group nurses by asking them two open‐ended questions 1 year later; 181 intervention group and 90 control group parents were also asked two open‐ended questions and to rate their infant's head shape.MethodsData were collected during the year 2013. Qualitative content analysis and case‐by‐case analysis were conducted using a process‐oriented approach.ResultsIntervention group nurses imparted both regular and newly introduced knowledge on positioning strategies to parents. Intervention group parents who perceived severe cranial asymmetry when infants were 3–4 months old reported implementing regular and new infant positioning recommendations.

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“…Positional head deformity is caused by external pressures on the rapidly developing skull from prolonged exposure to one position. It is reported that the risk factors for positional head deformity included premature delivery, multiple gestation, congenital muscular torticollis, oligohydramnios and other intra‐uterine constraint . With early detection and intervention, most positional head deformities can be treated conservatively with postural correction training or a head orthosis (‘helmet’) .…”

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confidence: 99%

Effect of helmet therapy in the treatment of positional head deformity

Wen

Qian

Zhang

et al. 2019

J Paediatrics Child Health

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Aim: Most positional head deformities can be treated conservatively with postural correction training or a head orthosis ('helmet'). We aimed to investigate whether infants with helmet therapy have cosmetic improvement in head deformity. Methods: A total of 376 infants at age 2-40 months who were diagnosed with mild-moderate-severe positional head deformity were enrolled. Among these infants, 101 infants were treated with helmet therapy or postural correction training. After matching by infant's age and time of therapy, three retrospective cohort studies of 56 infants were conducted for infants with plagiocephaly, brachycephaly and asymmetrical brachycephaly, respectively. The cephalic ratio (CR), radial symmetry index (RSI), cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) were compared between two groups before and after treatment. Results: Before treatment, no significant differences in CR, RSI, CVA and CVAI between groups were found. After treatment, compared with the postural correction training group, the helmet therapy group had significant improvements in CR, RSI, CVA or CVAI (Plagiocephaly: P CVA = 0.017, P CVAI = 0.028; Brachycephaly: P CR = 0.002; Asymmetrical brachycephaly: P RSI = 0.002, P CVA < 0.001, P CVAI < 0.001). Moreover, there was no significant difference in head circumference growth between the groups. Conclusions: Helmet therapy may be more effective in the treatment of mild-moderate-severe positional head deformity than postural correction training in infants. And helmet therapy may not hinder head circumference growth.

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Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses

Abstract: The evidence on the aetiology of DP is fragmentary and heterogeneous. In addition, factors possibly relevant to the development of DP have not been appreciated in the scientific discussion.

Cited by 66 publications

References 33 publications

A Prospective Study of Cranial Deformity and Delayed Development in Children

A Prospective Study of Cranial Deformity and Delayed Development in Children

Integrating new knowledge into practice: An evaluation study on a continuing education for Swedish child health nurses on non‐synostotic plagiocephaly

Effect of helmet therapy in the treatment of positional head deformity

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