Abstract
BackgroundPositional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard.MethodsOverall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution.ResultsAccording to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively.ConclusionsAccording to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.
Highlights
Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force
Previous researchers have stated that the diagnostic standards of plagiocephaly, brachycephaly, and dolichocephaly were cranial vault asymmetry (CVA) ≥ 0.3%, cephalic index (CI) ≥ 82%, and CI ≤ 76%, respectively [1, 7, 8]
Regarding the severity of plagiocephaly, mild plagiocephaly was the highest in each age group, and the detection rate of mild, medium, and severe plagiocephaly in the 2–3 and 4–5 months groups were significantly higher than those in the 0–1 month group; there were no significant differences in the detection rate of each degree of plagiocephaly between the 2–3 and 4–5 months groups (Table 3)
Summary
Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. Positional head deformity (PHD) refers to changes in the shape of an infant’s skull in the front, back, or sides due to an external force. Previous researchers have stated that the diagnostic standards of plagiocephaly, brachycephaly, and dolichocephaly were CVA ≥ 0.3%, CI ≥ 82%, and CI ≤ 76%, respectively [1, 7, 8] Nowadays, these are the most widely used diagnostic standards for determining PHD type and degree globally. There have been only a few relevant clinical studies, and there is no established diagnostic standard suitable for PHD cases among Chinese infants, which means diagnosis and prevention does not occur in the most effective treatment period [10]
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