310 Predictors of Preoperative Developmental Delay in Nonsyndromic Sagittal Craniosynostosis

Abstract

Patients with nonsyndromic sagittal craniosynostosis (SC) were previously thought to have normal neurocognitive development; however, a pattern of mild delays has been described in these patients. We reviewed our patients with SC to identify potential perinatal risk factors that serve as indicators for subsequent developmental delay.Nonsyndromic patients with SC (n = 66) completed preoperative Bayley Scales of Infant and Toddler Development (III) with a single examiner between August 2009 and April 2015. Patients were classified as having no delays (n = 52; 79%) or having delays (n = 14; 21%) below the ninth percentile in one or more area(s) of development. Mean differences were compared using Multivariate Analyses of Variance.Participants were mostly male (79%) and aged 2 to 12 months at testing. There were no group differences in sociodemographic categories. Prenatally, patients in the group with delays vs the group with no delays had lower gestational age in weeks (36.9 vs 39.2, P <.000) with higher rates of gestational diabetes (36% vs 6%, P =.002) and premature rupture of membranes (14% vs 0%, P =.006). There were no group differences in maternal hypertension, maternal age, breech position, preterm labor, emergency cesarean delivery, or failure to progress. At birth, patients with delays had lower birth weight in grams (2982 vs 3359, P =.041), higher rates of respiratory distress (29% vs 4%, P =.005), additional medical diagnoses (57% vs 15%, P =.001), and longer NICU stays in weeks (1.6 vs 0.2, P =.001). There were no differences for infection, hyperbilirubinemia, age at SC diagnosis, or subsequent surgery age.Patients with SC with delays in development had a lower gestational age and birth weight with more prenatal and birth complications. Further studies are required to validate appropriate follow-up and genetic testing in these groups.