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On the current incidence of deformational plagiocephaly: an estimation based on prospective registration at a single
Timothy R Littlefield1, Norman M Saba, Kevin M Kelly
1Cranial Technologies, Inc., 1395 W. Auto Drive, Tempe, AZ 85284, USA.
Insights
The Back to Sleep campaign led to more infant flat head syndrome (deformational plagiocephaly). Nearly 1 in 68 infants showed significant cranial asymmetry, indicating a rise in this condition.
Area of Science:
- Pediatrics
- Developmental Biology
- Public Health
Background:
- The American Academy of Pediatrics (AAP) recommended supine sleeping in 1992 to reduce sudden infant death syndrome (SIDS).
- A consensus suggests an increase in deformational plagiocephaly (infant head shape deformities) since this recommendation.
- The exact incidence of deformational plagiocephaly remains unknown.
Purpose of the Study:
- To estimate the current incidence of deformational plagiocephaly.
- To assess the prevalence of specific signs associated with plagiocephaly.
Main Methods:
- Examination of 342 infants for signs of deformational plagiocephaly.
- Documentation of occipital flattening, ear misalignment, frontal bossing, and facial asymmetry.
- Categorization of cranial deformities based on severity and involvement of skull base and face.
Main Results:
- Noticeable occipital flattening was documented in 15.2% of infants.
- 1.46% of infants exhibited significant cranial deformities affecting the skull base and face.
- Significant cranial asymmetry was observed in approximately 1 in 68 infants.
Conclusions:
- Findings suggest a significant increase in clinical deformational plagiocephaly.
- The rise in plagiocephaly correlates with the AAP's "Back to Sleep" campaign.
- Further research is warranted to understand the long-term implications and management of increased plagiocephaly rates.
Abstract:
In 1992, the American Academy of Pediatrics (AAP) recommended supine sleeping to reduce the risk of sudden infant death syndrome. Although the incidence of deformational plagiocephaly is unknown, the consensus is that it has increased since this recommendation was made. To estimate the current incidence of plagiocephaly, we examined 342 infants for signs of deformational plagiocephaly, including occipital flattening, ear misalignment, frontal bossing, and facial asymmetry. Noticeable occipital flattening was documented in 15.2% of the infants (95% confidence interval, 11.6% to 19.5%); 1.46% had significant cranial deformities that also affected the skull base and face. Significant cranial asymmetry, defined as occipital flattening with concomitant skull base involvement and facial asymmetry, was observed in almost 1 in 68 infants. Adding to a growing body of evidence, our findings suggest significant increases in clinical deformational plagiocephaly since initiation of the AAP's "Back to Sleep" campaign.
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