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Measuring for nonsynostotic head deformities in preterm infants during NICU management: A pilot study
Sarah Willis1, Robert Hsiao1, Ruth A Holland1
1Department of Neonatology, Wesley Medical Center, 550 N. Hillside St., Wichita, KS 67214, USA.
Early Human Development
|March 12, 2019
Summary
Nonsynostotic head deformities (NHD) like dolichocephaly and plagiocephaly are common in preterm infants during NICU stays. Head shape monitoring using cranial indices is reliable for tracking NHD progression in neonates.
Area of Science:
- Neonatal care
- Pediatric neurology
- Medical device technology
Background:
- Nonsynostotic head deformities (NHD) such as plagiocephaly, dolichocephaly, and brachycephaly are frequently observed in preterm infants.
- Existing research primarily focuses on NHD at discharge or post-discharge, with limited data during neonatal intensive care unit (NICU) stays.
Purpose of the Study:
- To gather quantitative data on head shapes in preterm neonates during their NICU hospitalization.
- To assess the prevalence and progression of NHD in this vulnerable population.
Main Methods:
- Weekly head measurements were conducted on 68 preterm infants (<34 weeks gestational age) during their NICU stay.
- Cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated using Ballert cranial caliper measurements.
- Inter-rater reliability for CI and CVAI was evaluated.
Main Results:
- CI consistently indicated dolichocephaly, while CVAI fluctuated, indicating plagiocephaly in a significant proportion of infants.
- Prevalence of dolichocephaly and plagiocephaly at discharge was 82% and 36%, respectively.
- The head measurement method demonstrated good to acceptable reliability and was time-efficient (1.1-1.9 minutes).
Conclusions:
- The cranial caliper method for tracking CI and CVAI during NICU stays is reliable.
- A substantial prevalence of nonsynostotic head deformities was observed in preterm neonates during their NICU hospitalization.
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