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Analysis of cranial type characteristics in term infants: a multi-center study
Wang Yang1, Bin Hu1, Jianping Chen2
1Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, 400037, Chongqing, China.
Insights
Positional head deformity (PHD) is common in Chinese infants, with high detection rates using international standards. A new localized diagnostic standard is proposed for better identification of plagiocephaly, brachycephaly, and dolichocephaly.
Area of Science:
- Pediatrics
- Craniofacial Development
- Public Health
Background:
- Positional head deformity (PHD) arises from external forces on an infant's skull, potentially causing cosmetic or neurological issues.
- Investigating PHD incidence and characteristics in term infants is crucial for early detection and intervention.
Purpose of the Study:
- To investigate the incidence and characteristics of positional head deformity (PHD) in term infants in China.
- To establish a localized diagnostic reference standard for PHD in the Chinese population.
Main Methods:
- Analyzed data from 4456 term infants across three medical institutions in Chongqing.
- Calculated Cranial Vault Asymmetry (CVA) and Cephalic Index (CI) for all infants.
- Applied current international diagnostic criteria to assess PHD incidence and distribution.
Main Results:
- The overall PHD detection rate in Chongqing term infants was 81.5% by international standards.
- Brachycephaly was the most frequent type (39.4%), followed by combined brachycephaly and plagiocephaly (34.8%).
- Specific CVA and CI percentiles were established, with notable age-related variations for plagiocephaly and brachycephaly.
Conclusions:
- Current international standards indicate a high PHD detection rate in Chinese term infants.
- A new localized diagnostic standard is proposed: CVA ≥ 0.4 cm for plagiocephaly, CI ≥ 91% for brachycephaly, and CI ≤ 82% for dolichocephaly.
Background:
Positional head deformity (PHD) is defined as a change in the shape of an infant's skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard.
Methods:
Overall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution.
Results:
According to the current international standards, the total detection rate of PHD in Chongqing's term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively.
Conclusions:
According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.
