Objectives Postural deformities are frequent in neonates. The moulded baby syndrome (MBS) comprises one or more of the following disorders: plagiocephaly, torticollis, congenital scoliosis, pelvic obliquity, adduction contracture of a hip, and/or malpositions of the knees or feet. We analyzed the incidence of MBS in healthy neonates and identified the risk factors of its composing elements.
Methods 1001 healthy neonates were examined on the second or third day of life by the same paediatrician. Familial, obstetrical, perinatal history and putative risk factors for postural deformities were collected. Families of newborns with a torticollis or plagiocephaly were given positioning advice and the outcome was evaluated by a phone survey 2 months later.
Results MBS was detected in 107 neonates (10.7%): 97 plagiocephalies or torticollis, 25 congenital scoliosis or pelvic obliquities, 13 malpositions of knees or feet. We identified risk factors related to the mother (age: OR = 1.39, parity: OR = 0.643), the obstetrical history (preterm labor: OR = 1.65, oligoamnios: OR = 10.179, breech presentation: OR = 2.746, pregnancy toxemia: OR = 3.773, instrumental delivery: OR = 6.028) and the newborn (male gender: OR = 1.982, birth length: OR = 1.196). The initial plagiocephaly or torticollis improved in 77% of infants after 2 months of stimulation and positioning measures.
Conclusions Paediatricians should be alert for the frequent but subtle MBS postural deformities, and give positioning advices to the parents. A neonate of male gender or greater birth length, with an older primiparous mother, a history of preterm labor, oligoamnios or pregnancy toxaemia, a breech presentation or an assisted delivery is more likely to have a MBS.