Background and aims Congenital cranial asymmetry is a precursor for the development of head deformities. However, early changes are often subtle and can be overlooked. Surface imaging improves detection of postnatal head deformities. The purposes of the present study were 1) to determine normative values of head shape at birth with a 3D laser system and 2) to identify potential risk-factors for congenital head shape abnormalities.

Methods In a cross-sectional study design healthy neonates born in a university hospital between 2/2013 and 3/2014 were scanned between 12 and 72 h after birth with a non-invasive laser scanner (STARScanner™). Normative values of established indices (Cranial Index - CI; Cranial Vault Asymmetry Index - CVAI) were computed. Infants with cranial asymmetry were analysed for pre- and perinatal risk factors.

Results Scans of 1095 newborns (m557, f538; 3373 ± 477g) were analysed. 1) Normative values of cranial measures and indices were calculated and are presented. 2) Cranial asymmetry was due to Cephalohematoma or Caput succedaneum in 4.5% of infants. In remaining infants it was not related to multiple birth, gender, gestational age, birth-presentation or delivery mode.

Conclusions The present study provides normative cranial data from 3D surface scans in a cohort of healthy newborns in the first 72 h of life. This allows a precise classification of head shape and an improved identification of abnormalities. In contrast to previous investigations, head asymmetry was not associated with any prenatal and perinatal factors. Long term consequences of congenital head shape abnormalities need to be further investigated in longitudinal studies.