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Delayed Motor Development and Infant Obesity as Risk Factors for Severe Deformational Plagiocephaly: A Matched
Eun-Hee Kim1,2, Ki Eun Kim2, Jihyun Jeon2
1Department of Pediatrics, Sejong Chungnam National University Hospital, Chungnam National University School of Medicine, Sejong, South Korea.
Insights
Deformational plagiocephaly risk factors include bottle-only feeding, limited tummy time, and delayed motor development. Infant obesity is identified as a novel risk factor for both mild and severe cases of this condition.
Area of Science:
- Pediatrics
- Developmental Biology
- Public Health
Background:
- Deformational plagiocephaly (DP) prevalence has risen, linked to infant sleep positioning recommendations.
- DP is influenced by a complex interplay of biological and environmental factors.
Purpose of the Study:
- To investigate the associations between deformational plagiocephaly and perinatal or infant characteristics.
- To identify risk factors, including infant obesity, associated with DP development and severity.
Main Methods:
- A case-control study involving 135 infants diagnosed with DP and 135 age- and sex-matched controls.
- Assessment of motor development using the Alberta Infant Motor Scale and obesity via body mass index.
- Logistic regression models were employed to analyze risk factors for DP and its severity.
Main Results:
- Bottle-only feeding (aOR=4.65), limited tummy time (aOR=3.51), delayed motor development (aOR=2.85), and infant obesity (aOR=2.45) were significant risk factors for DP.
- Delayed motor development (aOR=4.91) and obesity (aOR=4.10) were strongly associated with severe DP.
- Infant obesity emerged as a newly identified risk factor for deformational plagiocephaly.
Conclusions:
- DP risk is positively associated with bottle-only feeding, infrequent tummy time, and delayed motor development.
- Infant obesity is a significant and novel risk factor for deformational plagiocephaly.
- Early identification and comprehensive management of infant obesity are recommended for infants with DP.
Abstract:
The prevalence of deformational plagiocephaly (DP) has increased since the recommendation of positioning infants to their back during sleeping and is affected by various biological and environmental factors. This study aimed to investigate associations between DP and perinatal or infant characteristics, including obesity. This case-control study included 135 infants (81 males) aged 2-12 months who were diagnosed with DP using calculated cranial vault asymmetric index and cranial index and 135 age- and sex-matched controls. Motor development was evaluated using the Alberta Infant Motor Scale, and obesity was defined by body mass index. Univariate and multivariate logistic regression models were used to assess potential risk factors for DP and its severity. One hundred thirty-five infants with DP were divided into the following three subgroups according to severity indicated by the cranial vault asymmetry index: mild to moderate group (n = 87, 64.4%), severe group (n = 48, 35.6%), and a combined plagiocephaly and brachycephaly group (n = 79, 58.5%). Independent risk factors significantly associated with development of DP were bottle-only feeding (adjusted odds ratio (aOR) = 4.65; 95% CI: 2.70-8.00), little tummy time when awake (aOR = 3.51, 95% CI: 1.71-7.21), delay of motor development (aOR = 2.85, 95% CI: 1.08-7.49), and obesity at diagnosis (aOR = 2.45, 95% CI: 1.02-5.90). Among these risk factors, delay of motor development (aOR = 4.91, 95% CI: 1.46-16.51) and obesity at diagnosis (aOR = 4.10, 95% CI: 1.42-11.90) were particularly related to severe DP. In conclusion, this study confirms that DP risk is positively associated with bottle-only feeding, infrequent tummy time, and delayed development of motor milestones. Notably, this study demonstrates infant obesity as a new risk factor for DP. Our findings suggest that obesity should be identified early and managed comprehensively in infants with DP.
