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A 3D Follow-Up Study of Cranial Asymmetry from Early Infancy to Toddler Age after Preterm versus Term Birth
Anniina M Launonen1,2,3, Henri Aarnivala4,5,6, Panagiotis Kyteas7
1Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland. anniina.launonen@oulu.fi.
Insights
Preterm infants show more occipital flattening but develop deformational plagiocephaly (DP) similarly to full-term infants. Cranial asymmetry resolves at comparable rates in both groups by three years corrected age.
Area of Science:
- Pediatric medicine
- Neonatology
- Craniofacial development
Background:
- Preterm infants are susceptible to symmetrical and asymmetrical head molding.
- Deformational plagiocephaly (DP) is a common concern in infant head shape development.
Purpose of the Study:
- To compare cranial growth, molding, and DP incidence in preterm versus term-born children using 3D stereophotogrammetry.
- To assess the long-term resolution of cranial asymmetry in preterm infants.
Main Methods:
- Utilized 3D stereophotogrammetry to image 34 preterm infants and 34 term-born controls.
- Collected head images at 2-4 months, 5-7 months, 11-13 months, and 2.5-3 years corrected age.
- Analyzed oblique cranial length ratio (OCLR), cephalic index (CI), weighted asymmetry score (wAS), and flatness score (FS).
Main Results:
- No significant differences in OCLR, CI, or wAS between preterm and term groups.
- Preterm infants exhibited significantly greater occipital flattening (FS) at all time points (p < 0.05).
- DP incidence and resolution rates were similar; no severe DP observed, and moderate DP resolved after 5-7 months corrected age.
Conclusions:
- Deformational plagiocephaly affects preterm and full-term infants similarly in the first three years.
- Cranial asymmetry resolves at comparable rates in both groups after three months corrected age.
- Preterm infants present with increased occipital flattening compared to term-born infants.
Abstract:
Preterm infants are at higher risk for both symmetrical and asymmetrical head molding. This study involved 3D stereophotogrammetry to assess the cranial growth, molding, and incidence of deformational plagiocephaly (DP) in preterm children compared to term born children. Thirty-four preterm infants and 34 term born controls were enrolled in this study from Oulu University Hospital, Finland. Three-dimensional head images were obtained at the age of 2-4 months (T1), 5-7 months (T2), 11-13 months (T3), and 2.5-3 years (T4) from the term equivalent age (TEA). There was no statistically significant difference in oblique cranial length ratio (OCLR), cephalic index (CI), or weighted asymmetry score (wAS) between the two groups. Occipital flattening, defined by flatness score (FS) was statistically significantly greater in the preterm group than in the term group at T1-T4 (p < 0.05). In both groups, OCLR improved gradually over time. There were no instances, in either group, of severe DP and no moderate DP after T2. Results indicate that DP affects preterm and full-term children almost equally during the first three years of life, and cranial asymmetry resolves at a similar rate in both preterm and term groups after three months of corrected age. Preterm infants present with more occipital flattening than full-term children.
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