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Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years
  1. B L Hutchison1,
  2. A W Stewart2,
  3. E A Mitchell1
  1. 1Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
  2. 2Department of Population Health, The University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr B L Hutchison, Department of Paediatrics: Child and Youth Health, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; bl.hutchison{at}auckland.ac.nz

Abstract

Objectives To compare head shape measurements, parental concern about head shape and developmental delays in infancy with measurements obtained at follow-up at ages 3 and 4 years.

Design Longitudinal cohort study.

Setting Initial assessments were conducted at a plagiocephaly clinic; follow-up assessments were conducted in the children's homes.

Participants 129 children with a mean age of 4 years (range 3 years 3 months to 4 years 9 months), all of whom were diagnosed in infancy with deformational plagiocephaly or brachycephaly.

Main outcome measures Head shape measurements of cephalic index and oblique cranial length ratio; level of parental concern about head shape; and delays on parent-completed age-appropriate Ages and Stages Questionnaires.

Results 61% of head shape measurements reverted to the normal range; 4% remained severe at follow-up. Brachycephaly improved more than plagiocephaly. Facial and frontal asymmetry reduced to almost nil. Most had good improvement, but 13% were categorised as having 'poor improvement'. Initially, 85% of parents reported being 'somewhat' or 'very' concerned; this decreased to 13% at follow-up. The percentage of children with ≥1 delay decreased from 41% initially to 11% at follow-up.

Conclusions Overall, head shape measurements, parental concern and developmental delays in infancy showed a dramatic improvement when re-measured at 3 and 4 years of age.

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Footnotes

  • Funding This study was funded by the Child Health Research Foundation and the Auckland Medical Research Foundation.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Northern X Regional Ethics Committee; Auckland District Health Board Research Office.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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