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Published on: August 25, 2014
Incidence of Somatic Dysfunction in Healthy Newborns
Insights
Somatic dysfunction is common in newborns, affecting 99% of those studied. Longer labor durations were associated with increased somatic dysfunction severity in infants.
Area of Science:
- Pediatrics
- Osteopathic Manipulative Medicine
- Neonatal Health
Background:
- Osteopathic manipulative treatment may reduce newborn complications.
- The incidence of birth-related somatic dysfunction in newborns is not well-established.
Purpose of the Study:
- To determine the incidence and patterns of newborn somatic dysfunction.
- To correlate dysfunction with maternal/labor history and initial newborn assessments.
Main Methods:
- Physical examination of 100 healthy newborns (6-72 hours old) for cranial, cervical, lumbar, and sacral somatic dysfunction.
- Calculation of a Somatic Dysfunction Severity Score (SDSS).
- Correlation of SDSS with maternal/labor characteristics.
Main Results:
- 99% of newborns exhibited at least one sphenobasilar synchondrosis strain pattern.
- High incidences of condylar compression (95%), cervical (91%) and lumbar (94%) motion restriction, and posterior sacral base (80%) were observed.
- Increased labor duration correlated with higher SDSS (P=.04).
Conclusions:
- Somatic dysfunction is prevalent in healthy newborns across multiple regions.
- The severity of newborn somatic dysfunction is linked to labor duration.
Context:
Recent evidence suggests that osteopathic manipulative treatment of somatic dysfunction in newborns may decrease complications and hospital length of stay. Such dysfunction may result from external forces related to the birth process, but its incidence is unknown.
Objective:
To identify the incidence and patterns of somatic dysfunction in healthy newborns at least 6 hours after birth and to correlate those findings with maternal and labor history, gestational age, and findings of the initial newborn assessment performed immediately after birth.
Methods:
Healthy newborns aged 6 to 72 hours were physically examined and assessed for somatic dysfunction, including asymmetry and motion restriction of the cranial, cervical, lumbar, and sacral regions. The total somatic dysfunction identified was summarized in a somatic dysfunction severity score (SDSS), calculated by assigning 1 point for each identified finding; the SDSS could range from 0 (no somatic dysfunction) to 34 (all somatic dysfunctions assessed present). Findings were correlated with maternal and newborn characteristics and labor history. Descriptive analyses were performed, and findings were compared between the initial newborn assessment and the research examination.
Results:
One hundred newborns were examined (mean gestational age, 38.5 weeks). In 99 newborns (99%), at least 1 sphenobasilar synchondrosis strain pattern was present, with sidebending rotations being the most common (present in 63 newborns [63%]). Condylar compression was found in 95 newborns (95%), temporal bone restrictions in 85 (85%), motion restriction of at least 1 cervical vertebral segment in 91 (91%) and at least 1 lumbar vertebral segment in 94 (94%), and a posterior sacral base in 80 (80%). The SDSS was not associated with mode of delivery or labor augmentation (P=.49 and P=.54, respectively), but it was positively associated with the duration of labor; each 1-hour increase in labor increased the predicted SDSS by 0.12 points (P=.04).
Conclusion:
Somatic dysfunction of the cranial, cervical, lumbar, and sacral regions was common in healthy newborns, and the total somatic dysfunction (SDSS) was related to the length of labor. (ClinicalTrials.gov number NCT01496872).
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