Nonsynostotic plagiocephaly: a child health care intervention in Skaraborg, Sweden

The aim was to evaluate the intervention's effect on prevention and reversal of nonsynostotic plagiocephaly.

Thirty-eight intervention group nurses were educated about nonsynostotic plagiocephaly and asked to follow guidelines; 18 control group nurses were not. In a longitudinal single-blinded clinical intervention, parents brought infants to well-child visits according to the national schedule. Cranial shape was assessed in 176 intervention and 92 control group infants at 2-, 4-, and 12-month visits.

Asymmetry at two months reversed by four months four times more often in intervention than control subgroup infants (OR = 4.07, p = 0.02) when adjusted for parent awareness of written information from their nurse. Asymmetry at two months reversed by 12 months fivefold when parents were aware of written information (OR = 0.19, p = 0.04). The risk for persistent asymmetry at 12 months was lower for intervention than control group infants (RR = 0.35, p = 0.03). Of infants with no asymmetry at two months, 25% in intervention and 22% in control group developed brachycephaly.

The intervention contributed to early reversal and reducing infants' risk for persistent asymmetry. Parents' awareness of written information contributed to reversal. Preventing brachycephaly was difficult. Further research is needed.