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Positional Plagiocephaly Side and Neurodevelopmental Delay: Study on 408 Infants
Joan Pinyot1, David Lacambra1, Maria Garriga1
1Department of Pediatric Surgery, European Craniofacial Medical Center, Castellar del Vallès, Barcelona, Spain.
Insights
Positional plagiocephaly (PP) is linked to neurodevelopmental delays, particularly in males. The side of flattening significantly impacts the severity and type of delay observed in young children.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Craniofacial abnormalities
Background:
- Positional plagiocephaly (PP) is a common condition in infants characterized by skull flattening.
- Early identification and management of PP are crucial for optimal infant development.
- Understanding the neurodevelopmental implications of PP is essential for targeted interventions.
Purpose of the Study:
- To investigate neurodevelopmental delays in infants with positional plagiocephaly (PP).
- To analyze the impact of PP severity and flattening side on neurodevelopmental outcomes.
- To provide data for early childhood patient evaluation and management.
Main Methods:
- A cross-sectional study assessed 408 infants (3-59 months) with PP using Battelle Developmental Inventory (BDI) tests.
- Neurodevelopmental data were correlated with cranial measurements.
- Results were analyzed based on flattening side, diagnosis, severity, age, and sex.
Main Results:
- Significant neurodevelopmental delays were observed in over 75% of patients across both sexes.
- Males showed higher rates of delay (92.2% left, 95.5% right) compared to females (76.4% left, 75.5% right).
- Delays varied between 0.2 to 3 months depending on the flattening side and specific BDI domain.
Conclusions:
- Neurodevelopmental delays in infants with PP can vary based on the side of flattening.
- The side of plagiocephaly is a critical factor to consider during patient evaluation.
- This highlights the importance of assessing neurodevelopmental status in relation to plagiocephaly presentation.
Objective:
Provide data on a cross-sectional study of neurodevelopmental delays in positional plagiocephaly (PP) based on severity and flattening side on early childhood patients.
Methods:
Neurodevelopment of 408 PP in patients with an age range of 3 to 59 months was assessed with Battelle Developmental Inventory (BDI) tests during and after their cranial orthotic treatment. Data obtained were compared with the cranial anthropometric measurements taken the same day the test was made, and results were segregated by flattening side, grouped by diagnosis and severity, segmented by age group, and split by sex.
Results:
From 3983 patients with positional skull deformities and simple craniosynostosis, 526 patients accepted to participate and took a total of 1261 BDI tests. Premature, patients with neurological diseases, cranial malformations, tests taken when positional skull deformity was corrected, and tests without plagiocephaly were excluded. The resulting database was made of 408 PP patients (300 boys and 108 girls) and 883 BDI tests (345 with left-side plagiocephaly and 538 with right-side plagiocephaly). Significant neurodevelopmental delay in more than one BDI domain on left-side plagiocephaly tests is observed in 76.4% of female and 92.2% of male patients and on right-side plagiocephaly tests in 75.5% of female and 95.5% of male patients. Neurodevelopmental delay difference between flattening sides, when both plagiocephaly sides presented significant delays, ranges from 0.2 to 3 months (BDI domain fine motor, Cephalic Index range ≥85 <100; BDI communication, age group 18-23).
Conclusion:
Neurological delay may vary depending on plagiocephaly side, thus when evaluating plagiocephaly patients the flattening side should be noted.
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