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Dolichocephaly in Preterm Infants: Prevalence, Risk Factors, and Early Motor Outcomes
Dana B McCarty1, Jennifer R Peat2, William F Malcolm3
1Division of Physical Therapy, Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Insights
Dolichocephaly, a head shape deformity, is common in preterm infants, peaking between 32-34 weeks postmenstrual age. Early intervention is recommended to improve motor outcomes.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Pediatric Physical Therapy
Background:
- Dolichocephaly is a cranial molding deformity that can affect preterm infants.
- Understanding its development and impact on motor outcomes is crucial for timely intervention.
Purpose of the Study:
- To determine the onset of dolichocephaly in preterm infants.
- To identify factors associated with its development.
- To assess the link between dolichocephaly and adverse motor outcomes.
Main Methods:
- Retrospective review of data from preterm infants (<32 weeks' gestation).
- Cranial index measured by physical therapists at three intervals.
- Collection of demographic data, neonatal morbidities, and motor outcomes.
Main Results:
- 54% of preterm infants developed dolichocephaly during hospitalization.
- Dolichocephaly was most prevalent between 32-34 weeks' postmenstrual age (PMA).
- Infants with dolichocephaly at 32-34 weeks' PMA showed a higher need for physical therapy (PT) services.
Conclusions:
- Dolichocephaly is common in preterm infants, particularly between 32-34 weeks' PMA.
- The condition is associated with an increased requirement for early physical therapy.
- Early developmental intervention for preterm infants (<32 weeks' PMA) may prevent cranial deformities and enhance motor development.
Abstract:
Objective The purpose of this study was to determine when dolichocephaly develops in preterm infants, to establish factors that contribute to its development, and to determine its association with adverse motor outcomes. Study Design This study was a retrospective review of data collected from preterm infants born at < 32 weeks' gestation. The cranial index was measured by a physical therapist (PT) at three time points during hospitalization. Demographic data, neonatal morbidities, and motor outcomes at outpatient follow-up were collected. Results Overall, 54% of infants developed dolichocephaly during hospitalization. The presence of dolichocephaly was highest in infants between 32 and 34 weeks' postmenstrual age (PMA) (39%). Birth weight, gestational age, bronchopulmonary dysplasia, gastroesophageal reflux disease, and severe intraventricular hemorrhage were not associated with dolichocephaly. Infants with dolichocephaly at 32 to 34 weeks' PMA were more likely to either be receiving PT services or be referred to PT services by outpatient follow-up (p = 0.05). Conclusion The presence of dolichocephaly was highest in infants between 32 and 34 weeks' PMA and was associated with increased need for PT services in early infancy. Findings support early developmental intervention at < 32 weeks' PMA to prevent and/or treat cranial molding deformity and improve early motor outcomes.
