NEW YORK (Reuters Health) – A number of factors, including gender and favorite head position, influence the severity of deformational plagiocephaly in infants, according to a report in The Journal of Craniofacial Surgery for March.

“Unlike prior reports of risk factors for developing plagiocephaly, the current study sought to identify variables that correlated with the severity of cranial flattening in affected infants,” lead author Dr. Albert K. Oh, from the Alpert Medical School of Brown University in Providence, Rhode Island, and colleagues point out.

The study included 434 babies who were seen at Children’s Hospital Boston and Hasbro Children’s Hospital from 2006 to 2007. Risk factors for deformational plagiocephaly were assessed via parental questionnaire, which was administered before the child’s clinical evaluation in order to reduce bias.

Males outnumbered females 2 to 1 and the average gestational age was 36.5 weeks, the report indicates. On average, deformational plagiocephaly was first detected at 6 weeks of age. Fewer than 50% of the subjects had a prior diagnosis of torticollis, but 80% of infants had head tilt and the average head rotational asymmetry was 16.4 degrees.

Correlates of more severe plagiocephaly included multiple birth pregnancy, male gender, a favorite head position, torticollis diagnosis, and head tilt (p < 0.05 for all), the authors note. Younger gestational age and greater head rotational asymmetry were also predictive of more severe flattening. Maternal factors, by contrast, had little bearing on the severity of plagiocephaly, the report indicates. Summing up, the investigators say the presence and degree of cervical imbalance “correlate strongly” with deformational cranial asymmetry. “This study is significant because we were able to find direct correlations between a variety of variables and the severity of deformational plagiocephaly in infants,” Dr. Oh said in a statement. “Ultimately we have shown that there are certain clear risk factors for more severe flattening in infants.” Reference:
J Craniofac Surg 2009;20.