Prevalence of head deformities in preterm infants at term equivalent age

Abstract

Introduction: Due to a rising number of head deformities in healthy newborns, there has been an increasing interest in nonsynostotic head deformities in children over recent years. Although preterm infants are more likely to have anomalous head shapes than term newborns, there is limited data available on early prevalence of head deformities in preterm infants.

Aims: The purposes of the present study were to acquire quantitative data on head shape of preterm infants at Term Equivalent Age (TEA), to determine the prevalence of symmetrical and asymmetrical head deformities and to identify possible risk factors.

Methods: In a cross-sectional study design, Cranial Vault Asymmetry Index (CVAI) and Cranial Index (CI) calculated from routine head-scans with a non-invasive laser shape digitizer were recorded and categorized in type and severity of deformation for three different groups of gestational age. Perinatal and postnatal patient data was tested for possible associations.

Results: Scans of 195 infants were included in the study. CVAI at TEA was higher in very preterm (4.1%) compared to term and late preterm infants. Prevalence of deformational plagiocephaly was 38% in very preterm infants. CI was lower in very (71.4%) and late (77.2%) preterm infants compared to term infants (80.0%). Compared to term babies (11%), a large number of very (73%) and late (28%) preterm infants exhibited dolichocephaly at TEA.

Discussion: Prevalence of symmetrical and asymmetrical head deformities in preterm infants is high at TEA. Interventions are required to prevent head deformities in preterm infants during the initial hospital stay.

Keywords: 3D; BPD; Bronchopulmonary Dysplasia; CI; CPAP; CS; CVAI; Cephalometry; Cesarean Section; Continuous Positive Airway Pressure; Cranial Index; Cranial Vault Asymmetry Index; DP; Deformational Plagiocephaly; Dolichocephaly; GA; Gestational Age; HC; Head Circumference; Head growth; ICH; IMC; IMV; IQR; Infant preterm; Intermediate Care; Interquartile Range; Intracranial Hemorrhage; Invasive Mechanical Ventilation; Max; Maximum; Min; Minimum; NEC; Necrotizing Enterocolitis; OR; Odds Ratio; PMA; Plagiocephaly; Postmenstrual Age; TEA; Term Equivalent Age; Three-Dimensional.