Measuring for nonsynostotic head deformities in preterm infants during NICU management: A pilot study

Research has focused on the presence of nonsynostotic head deformities (NHD: plagiocephaly, dolichocephaly, brachycephaly) in preterm infants at discharge and within the first year after discharge. However, there is limited data on NHD in preterm neonates during neonatal intensive care unit (NICU) stay.

To acquire quantitative data on head shapes among preterm neonates during NICU hospital stay.

Investigators performed weekly head measurements on 68 premature infants starting within two weeks of birth or when medically stable until discharge. Infants recruited for the study were born at <34 weeks gestational age.

Cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated from Ballert cranial caliper measurements during the infants stay (27 to 40 weeks postmenstrual age) in the NICU/Special Care Nursery (SCN) setting. Inter-rater retest reliability was determined for CI and CVAI.

Throughout the measurement period, CI consistently demonstrated dolichocephaly (CI < 0.76), and CVAI fluctuated above and below the range indicating plagiocephaly (CVAI ≥ 3.5%). Good to acceptable levels of test-retest reliability was demonstrated; prevalence of dolichocephaly and plagiocephaly at discharge was 82% and 36%, respectively; and mean head dimension measurement time for different combinations of bed types and support systems ranged from 1.1 to 1.9 min.

Following the progression of CI and CVAI during the NICU stay using the cranial caliper method is reliable, and a substantial presence of NHD was reported.