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Prevailing head position to one side in early infancy-A population-based study
Elisabeth J M Straathof1, Kirsten R Heineman1,2, Elisa G Hamer1,3
1University of Groningen, Department of Paediatrics - Division of Developmental Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Insights
Prevailing head position to one side (PHP) is common in infants, decreasing with age. While not concerning at 2-3 months, PHP at 4-5 months may signal developmental challenges.
Area of Science:
- Developmental Pediatrics
- Infant Health
- Neuromotor Development
Background:
- Prevailing head position to one side (PHP) is a common observation in young infants.
- Understanding its prevalence and associations is crucial for early developmental assessment.
Purpose of the Study:
- To determine the prevalence of prevailing head position to one side (PHP) in young infants.
- To evaluate associations between PHP and reaching performance, neurological status, and perinatal/socio-economic factors.
Main Methods:
- An observational study of 500 infants (2-6 months corrected age) representative of the Dutch population.
- Assessment of PHP and reaching using the Infant Motor Profile.
- Neurological condition evaluated with the Standardized Infant NeuroDevelopmental Assessment; data collected via questionnaires and medical records.
Main Results:
- PHP was observed in 20% of infants, decreasing from 49% at 2 months to 0% at 6 months.
- PHP at 4-5 months was significantly associated with poorer reaching performance and at-risk neurological scores.
- Weak associations were found between PHP and prenatal substance exposure, postnatal hospital admission, and paternal Dutch background.
Conclusions:
- PHP at 2-3 months is common and generally has limited clinical significance.
- PHP at 4-5 months is a potential red flag, indicating possible challenges in functional and neurological development.
- Early identification of PHP at 4-5 months may prompt further developmental evaluation.
Aim:
To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio-economic factors.
Methods:
Observational study in 500 infants (273 boys) 2-6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27-42); birthweight 3438 g (1120-4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio-economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni- and multivariable statistics.
Results:
Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4-5 months PHP was significantly associated with worse reaching and an at-risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post-natal admission to a paediatric ward and paternal native Dutch background.
Conclusion:
Prevailing head position to one side at 2-3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4-5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4-5 months could serve as a red flag indicating possible challenges in later development.
