Developmental Delay in Infants With Positional Skull Deformity

Abstract

Research Article| July 01 2021 Developmental Delay in Infants With Positional Skull Deformity AAP Grand Rounds (2021) 46 (1): 4. https://doi.org/10.1542/gr.46-1-4 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share MailTo Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Developmental Delay in Infants With Positional Skull Deformity. AAP Grand Rounds July 2021; 46 (1): 4. https://doi.org/10.1542/gr.46-1-4 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: developmental delay, plagiocephaly, skull malformation Source: Rohde JF, Goyal NK, Slovin SR, et al. Association of positional plagiocephaly and developmental delay within a primary care network. J Dev Behav Pediatr. 2021;42(2):128-134; doi: https://doi.org/10.1097/DBP.0000000000000860Google Scholar Investigators from Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, conducted a retrospective study to assess the association between plagiocephaly and developmental delay among a cohort of children seen in primary care offices and the relative timing of plagiocephaly and developmental delay. For the study, they reviewed data obtained from 45 primary care sites within a single health care system and abstracted data on patients <5 years old who had a first primary care office visit by the age of 12 months between 2000 and 2017. Children with a plagiocephaly diagnosis by 12 months were identified by ICD-9 and ICD-10 codes. Controls were patients seen by 12 months without a diagnosis of plagiocephaly. Data on demographics, history of prematurity, and diagnoses of abnormal tone and torticollis also were abstracted. The primary study outcome was a diagnosis of developmental delay, identified with ICD-9 and ICD-10 codes, assigned by a primary care provider. Secondary outcomes included diagnoses of specific types of developmental delay. The dates of first diagnosis of plagiocephaly and developmental delay were obtained. The association between demographic and clinical characteristics and plagiocephaly was assessed with chi-square or Fisher exact tests. Logistic regression was used to determine if plagiocephaly was independently associated with developmental delay and specific types of delay. Data were analyzed on 77,108 children, including 2,315 (3.0%) diagnosed with plagiocephaly by the age of 12 months. The median age of diagnosis was 3 months. Children diagnosed with plagiocephaly were significantly more likely to be male, white, have private insurance, and to have been born prematurely than controls (all P values <0.001). Diagnoses of abnormal tone (P <0.001) and torticollis (P <0.001) also were significantly associated with plagiocephaly. Developmental delay was diagnosed in 404 (17.5%) of those with plagiocephaly and 6,492 (8.7%) of controls. After controlling for confounding variables, plagiocephaly was independently associated with developmental delay (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.32, 1.70). Among specific types of developmental delay, plagiocephaly was associated with an increased odds for motor delay (OR, 1.67; 95% CI, 1.29, 2.16), language delay (OR, 1.35; 95% CI, 1.17, 1.56), and general delay (OR, 1.77; 95% CI, 1.39, 2.24), but not social delay (OR, 2.72; 95% CI, 0.87, 8.50) or cognitive delay (OR, 0.36; 95% CI, 0.11, 1.23). The diagnosis of plagiocephaly preceded that of developmental delay in 374 of 406 children (92.6%) with both conditions. The authors conclude that among a cohort of children seen in primary care offices there was an association between plagiocephaly and developmental delay. Dr Badawi has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Deformational plagiocephaly and brachycephaly result from prolonged forces applied to the back... You do not currently have access to this content.