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Cranial shape, size and cervical motion in normal newborns
Henri E I Aarnivala1, A Marita Valkama2, Pertti M Pirttiniemi3
1Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland; University of Oulu, Oulu, Finland.
Insights
Deformational plagiocephaly (DP) and torticollis are common in newborns. Cranial shape, not asymmetry, is linked to cervical motion at birth, suggesting conditions develop postnatally.
Area of Science:
- Neonatal health
- Pediatric physical therapy
- Craniofacial development
Background:
- Deformational plagiocephaly (DP) and torticollis are frequently observed in infants, often co-occurring.
- Limited data exists on their prevalence and relationship in the immediate newborn period.
- No prior studies have investigated the link between cranial shape and cervical motion in neonates.
Purpose of the Study:
- To determine the incidence rates and characteristics of DP and torticollis in neonates.
- To examine the relationship between cervical range of motion (ROM), cranial size, and cranial shape in newborns.
- To investigate potential associations between neonatal cranial morphology and cervical function.
Main Methods:
- A descriptive cross-sectional study of 155 healthy neonates during birth hospitalization.
- Measurement of Oblique Cranial Length Ratio (OCLR) and Cephalic Index (CI) using computer-based cephalometry from digital photographs.
- Assessment of cervical range of motion (ROM) using goniometry.
Main Results:
- Incidence rates: 7.7% for DP, 3.9% for torticollis, and 46.4% for minor cervical imbalances.
- DP associated with gestational diabetes and vacuum-assisted delivery; no association with torticollis.
- Cephalic Index (CI) strongly correlated with cervical ROM; cranial asymmetry showed no clear association with cervical motion.
Conclusions:
- DP and torticollis are common in newborns, with minor cervical imbalances also prevalent.
- Findings suggest DP and torticollis typically develop postnatally rather than being congenital.
- While direct association between DP and torticollis was not found, cranial shape is linked to cervical motion at birth.
Background:
Deformational plagiocephaly (DP) and torticollis are commonly seen in infants and they often co-occur, but little is known of the prevalence and relationship of these conditions in the immediate newborn period. No previous studies focusing on the relationship between cranial shape and cervical motion in newborns can be found.
Objectives:
Determining the incidence rates and characteristics of DP and torticollis and examining the relationship between cervical range of motion (ROM), cranial size and cranial shape in neonates.
Methods:
A single-center, descriptive cross-sectional study including 155 healthy neonates was conducted. Participants were examined during their birth hospitalization. Oblique Cranial Length Ratio (OCLR) and Cephalic Index (CI), indicating cranial asymmetry and shape, were measured from standardized digital photographs with a computer-based cephalometric method. Cervical ROM was measured with goniometry.
Results:
7.7% of the newborns had DP and 3.9% had torticollis. 46.4% presented lesser cervical imbalances. DP was associated with gestational diabetes (adjusted OR 5.6; p<0.01) and vacuum assisted delivery (adjusted OR 6.8; p<0.01), but not at all with torticollis. CI correlated strongly with cervical ROM in all directions, while no definite association between cranial asymmetry and cervical motion could be found.
Conclusions:
DP and torticollis are common and minor cervical imbalances very common in normal newborns. Our results support the theory that in most cases neither DP nor torticollis is congenital, but rather develops and worsens synergistically in early infancy. Still, although no direct association between DP and torticollis was found, cranial shape is linked to cervical motion at birth.
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