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Published on: February 5, 2019
Evaluating the effectiveness of gel pillows for reducing bilateral head flattening in preterm infants: a randomized
Alyce A Schultz1, Patricia A Goodwin, Cynthia Jesseman
1Center for Advancement of Evidence-Based Practice, Arizona State University, Tempe, AZ, USA.
Insights
Gel pillows did not significantly reduce head molding (plagiocephaly) in preterm infants. Further research is needed to explore potential benefits for smaller infants requiring longer hospital stays.
Area of Science:
- Neonatal care
- Pediatric orthopedics
- Medical device evaluation
Background:
- Premature infants are at high risk for positional plagiocephaly.
- Head molding can lead to cosmetic and potentially functional concerns.
- Current interventions for plagiocephaly in preterm infants vary in effectiveness.
Purpose of the Study:
- To assess the efficacy of gel pillows in mitigating bilateral head molding in preterm infants.
- To determine if gel pillows influence the cephalic index (CI) in this vulnerable population.
Main Methods:
- Eighty-one preterm infants (<1,500 g) were randomized to either standard care or a gel pillow.
- Cephalic index (CI) was measured weekly using a digimatic caliper.
- Repeated measures analysis of variance was employed to analyze CI changes over time.
Main Results:
- No statistically significant differences in cephalic index (CI) were observed between the gel pillow and standard care groups.
- Trends suggested potential benefits for smaller infants on gel pillows with longer hospitalizations, but were not statistically significant.
- The study was underpowered to detect subtle differences in CI.
Conclusions:
- Gel pillows, as used in this study, did not demonstrate a significant effect on reducing plagiocephaly in preterm infants.
- Further investigation with larger sample sizes may be warranted to explore potential benefits in specific subgroups of preterm infants.
- The findings suggest that current standard care practices may be as effective as gel pillow use for this outcome.
Abstract:
This study evaluated the effectiveness of gel pillows for reducing bilateral head molding (plagiocephaly) in preterm infants, as determined by the cephalic index (CI). Eighty-one infants weighing <1,500 g were randomly assigned at birth to usual care on a standard mattress (n = 40) or to placement on a gel pillow (n = 41). The CI was measured with a digimatic caliper upon entry and weekly thereafter, until infants had been transferred or discharged. Repeated measures analysis of variance revealed no statistically significant differences in the CI between subjects upon entry, at 5 weeks postintervention, or at 10 weeks postintervention. The trend was toward less molding over time for smaller infants on gel pillows who were hospitalized longer; however, the sample size was too small to detect statistical significance.