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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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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