The course of skull deformation from birth to 5 years of age: a prospective cohort study.

Abstract

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.

MAIN FINDINGS:

(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.

CONCLUSION:

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.

• Authors: Leo A van Vlimmeren, Raoul Hh Engelbert, Maaike Pelsma, Hans Mm Groenewoud, Magda M Boere-Boonekamp, Maria Wg Nijhuis-van der Sanden
• Journal: European journal of pediatrics (Eur J Pediatr) Vol. 176 Issue 1 Pg. 11-21 (Jan 2017) ISSN: 1432-1076 [Electronic] Germany
• PMID: 27815732 (Publication Type: Journal Article, Randomized Controlled Trial)

Topics

• Child, Preschool
• Craniosynostoses (classification, diagnosis, therapy)
• Female
• Humans
• Infant
• Infant, Newborn
• Longitudinal Studies
• Male
• Physical Therapy Modalities
• Plagiocephaly, Nonsynostotic (classification, diagnosis, therapy)
• Prospective Studies
• Risk Factors
• Skull (abnormalities)
• Supine Position