Prevalence of positional skull deformities in 530 premature infants with a corrected age of up to 6 months: a multicenter study

Abstract

BackgroundPositional deformities (PD) are common during early infancy. Severe cases may result in facial abnormalities and be associated with delayed neurological development in infants. The earlier the detection of PD, the better the intervention effect and the lower the cost of treatment. Currently, there are many studies on PD in Europe and the United States. However, in China, there is little data on the basic metrics and incidence of PD. Premature infants have a high risk of PD. However, there are few studies on PD in premature infants globally, and none in Asia. This study aimed to investigate PD and its characteristics inpremature infants to help its early detection and intervention and thus improve the quality of life for premature infants.MethodsWe analyzed 530 preterm infants who visited the outpatient departments at Xinqiao Hospital of Army Medical University and Maternal and Child Health Care Hospitals of Wanzhou and Yongchuan Districts in Chongqing from September 1, 2016, to August 31, 2017. The head shape data measured by a simple manual method were recorded. The diagonal difference (DD) between the transcranial diagonals and the cranial index (CI) was calculated. PD and its incidences indifferent gestational ages and corrected age groups were analyzed.ResultsAccording to previously defined international diagnostic criteria, the incidence of plagiocephaly, brachycephaly, and dolichocephaly were 51.1, 85.1, and 3.0% respectively, and those of right and left plagiocephalywere69.4 and 30.6%, respectively. The incidence of PD was highest among infants with a gestational age of < 32 weeks and decreased as the gestational age increased. As the corrected age (CA) increased, the incidence of plagiocephaly and dolichocephaly decreased, and the incidence of brachycephaly increased.ConclusionsPD incidence is high among preterm infants. As gestational age decreased, PD incidence and severity increased. Therefore, healthcare providers should implement early PD detection and intervention to prevent the adverse outcomes. The extremely high incidence of brachycephaly and extremely low incidence of dolichocephaly in this study are likely to be due to the variance of cranial metrics caused by cultural differences. The Chinese standards for infant cranial measurements must be established.

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

“…In China, because of the impact of socioeconomic problems and insufficient knowledge regarding PHD, people lack awareness about its harmful effects. Furthermore, there have been only a few relevant clinical studies, and there is no established diagnostic standard suitable for PHD cases among Chinese infants, which means diagnosis and prevention does not occur in the most effective treatment period [ 10 ].…”

Two-Dimensional Image-Based Screening Tool for Infants with Positional Cranial Deformities: A Machine Learning Approach

“…Therefore, currently, positional cranial deformity is a relatively common problem faced by parents and physicians. Specifically, in the first few months, cranial deformities in infants have more prevalence on the occipital bone, manifested as unilateral or bilateral flattening [ 1 , 2 ]. According to a prior study, the prevalence of positional skull deformities at the age of 6 weeks is 16% and decreases to 3.3% by the age of 24 months [ 3 ].…”

“…These cranial deformities are diagnosed and quantified based on the following clinical features: (1) deformational brachycephaly is a bilateral symmetric occipital flattening with a parietal widening induced as a compensatory reaction characterized by an increase in the cranial width-to-length ratio; (2) deformational plagiocephaly is a single-sided oblique flattening on the back of the head and comparable to a trapezoidal shape. This asymmetric growth is often accompanied by a frontal face asymmetry [ 1 , 5 ]. Sociodemographic and socioeconomic factors, including young parents or low-educational status, and obstetric factors such as multiparity, delivery complications, or prematurity, increase the risk of positional head deformities.…”

Analysis of Cranial Type Characteristics in Term Infants: A Multi-center Study

“…In China, due to the impact of socioeconomic problems and insu cient knowledge of PHD, people lack awareness of the harm it causes. Furthermore, there have been few relevant clinical studies, and no diagnostic standard established is suitable for PHD among Chinese infants, which means diagnosis and prevention miss the most effective treatment period (10).…”