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Updated: Jun 13, 2025
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Ultrasonographic Measurement of Anterior Fontanelle Size in Infants with Deformational Plagiocephaly
Jae Hee Lee1, Gi-Young Park1, Dong Rak Kwon1
1Department of Rehabilitation Medicine, School of Medicine, Daegu Catholic University, Nam-gu, Daegu 42472, Republic of Korea.
Insights
Anterior fontanelle size decreases with infant age but shows no link to deformational plagiocephaly severity. Fontanelle size is also not correlated with developmental delays in infants.
Area of Science:
- Pediatric medicine
- Craniofacial abnormalities
- Developmental pediatrics
Background:
- Deformational plagiocephaly (DP) is a common condition in infants.
- The relationship between DP severity, anterior fontanelle size, and developmental outcomes requires further investigation.
Purpose of the Study:
- To examine the association between the severity of deformational plagiocephaly and anterior fontanelle size.
- To explore the potential link between anterior fontanelle size and developmental delays in infants.
Main Methods:
- 189 infants with plagiocephaly were assessed for cranial vault asymmetry (CVA) and anterior fontanelle size via radiography and ultrasonography.
- DP severity was graded using the Argenta classification.
- 40 infants underwent the Denver Developmental Screening Test II (DDST-II) to assess for developmental delays.
Main Results:
- A significant negative correlation was found between infant age and anterior fontanelle size (p < 0.05).
- No significant differences in fontanelle size were observed based on DP severity (CVA groups) or developmental delay status (p > 0.05).
- The study found no correlation between CVA and fontanelle size, nor between fontanelle size and developmental delay.
Conclusions:
- Anterior fontanelle size diminishes with increasing infant age.
- Fontanelle size does not appear to be a reliable indicator for the severity of deformational plagiocephaly.
- There is no significant association between anterior fontanelle size and the presence of developmental delays in infants.
Abstract:
Background/Objectives: We aimed to investigate the relationship between deformational plagiocephaly (DP) severity and anterior fontanelle size and to explore the connection between fontanelle size and developmental delay. Methods: We enrolled 189 (122 boys and 67 girls; mean corrected age, 119.79 days) of the 256 infants who visited our clinic for plagiocephaly between March 2022 and June 2023. This study analyzed the correlation between cranial vault asymmetry (CVA) and anterior fontanelle size as measured using skull anteroposterior (AP) radiography and ultrasonography. The severity of DP was graded from minimal to severe based on the Argenta classification. Infants were grouped according to CVA severity as follows: Group 1 (CVA ≤ 5 mm), Group 2 (5 mm < CVA < 10 mm), and Group 3 (CVA ≥ 10 mm). Additionally, 40 infants underwent the Denver Developmental Screening Test II (DDST-II) for neurodevelopmental delays and were divided into groups based on the presence or absence of developmental delays for fontanelle size comparison. Results: Age showed a significant negative correlation with fontanelle size (correlation coefficient -0.234, p < 0.05), indicating that fontanelle size decreases as infants age. No significant differences in fontanelle size were observed among the three CVA groups (p = 0.074) or between the developmentally delayed and non-delayed groups (p = 0.09). This study found no correlation between CVA and fontanelle size or between fontanelle size and developmental delay. Conclusions: The findings show that, while anterior fontanelle size decreased with age, there was no significant correlation between the fontanelle size and the severity of deformational plagiocephaly or developmental delays.
