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Published on: February 2, 2015
Prevention of deformational plagiocephaly in neonates
Ariane Cavalier1, Marie-Christine Picot, Cecile Artiaga
1CH Intercommunal du Bassin de Thau, Service de Pediatrie, F-34200 Sete, France.
Insights
Early intervention encouraging infant movement significantly reduces deformational plagiocephaly (DP) prevalence. This suggests movement, not just supine positioning, is key to preventing DP.
Area of Science:
- Pediatrics
- Neonatal Care
- Developmental Pediatrics
Background:
- Deformational plagiocephaly (DP) incidence has risen since the 1990s, with a potential link to the "back to sleep" campaign.
- Recent research indicates supine positioning may be a risk factor for DP only when combined with other environmental factors.
- Understanding environmental influences on infant head shape is crucial for preventative strategies.
Purpose of the Study:
- To assess the effectiveness of early environmental interventions on newborn infants.
- To evaluate the impact of encouraging physical movement on the prevalence of DP at four months of age.
Main Methods:
- A multicenter, prospective, controlled study involving healthy term neonates.
- Infants received standard "back to sleep" guidance; the intervention group also received encouragement for spontaneous physical movement.
- Plagiocephaly and environmental factors were assessed at 1, 2, and 4 months.
Main Results:
- The intervention group (n=88) demonstrated significantly more unhindered movement (lower immobility score) compared to the control group (n=51).
- Prevalence of DP was substantially lower in the intervention group (13%) versus the control group (31%).
- Each additional hour of infant immobility between months 3-4 doubled the risk of developing DP by 4 months.
Conclusions:
- Early postnatal interventions promoting physical movement on maternity wards effectively reduce DP prevalence.
- The rise in DP incidence may be linked to reduced physical stimulation rather than solely supine positioning.
- Encouraging infant movement is a vital component in preventing deformational plagiocephaly.
Background:
Since the early 90s a striking rise in deformational plagiocephaly (DP) has been reported, and a causal link between the "back to sleep" position recommended to reduce the risk of sudden infant death syndrome. Recent data suggested that supine position is a risk factor only when combined with other environmental factors
Objective:
To evaluate the impact of early intervention in the newborn environment on the prevalence of DP at 4 months of life.
Methods:
A multicentric, prospective, controlled study in healthy term neonates. Within 72 h of birth, all parents received the usual recommendations for positioning their infants to prevent sudden infant death syndrome. In the Intervention group, recommendations were also given to encourage spontaneous and unhindered physical movement. At 1, 2 and 4 months, we looked for plagiocephaly and collected information on the infants' environment.
Results:
The environment of the Intervention group (n = 88) was significantly more favorable to unhindered movement than in the control group (n = 51) (lower immobility score, p < 0.01). The prevalence of DP was significantly lower in the Intervention group than in the control group (13% vs. 31%, p < 0.001). For each supplementary hour of immobility during the third and fourth months of life, the risk of DP at four months doubled (OR:2.1[1.4-3.2]).
Conclusion:
Early postnatal intervention on the maternity ward reduces the prevalence of DP. The recent rise in the incidence of DP could be related to a lack of stimulation and encouragement to physical movement rather than to supine positioning proposed for prevention of sudden infant death syndrome.
