Cephalhaematoma in Sweden, a Population-Based Register Study

The primary aim was to investigate the incidence, birth characteristics, and timing of diagnosis of cephalhaematoma (CH). The secondary aim was to explore associations between CH and complications during the neonatal period and infancy.

This is a nationwide population-based register study of infants (< 12 months) born in Sweden from 1997 to 2018. Information was retrieved from health registers of the Swedish National Board of Health and Welfare. Cases were infants with a diagnosis of birth-related CH.

The study comprises 2930 infants with CH. The incidence was 2.2 per 1000 births and increased during the study period. Most CH cases had a spontaneous vaginal delivery. Risk factors were ventouse, born preterm, large-for-gestational age, and occiput posterior presentation. Two-thirds were diagnosed before 7 days of life. A delayed diagnosis during later infancy became more common from the year 2000. Newborn infants had an increased risk of jaundice (10%). CH was associated with hypoxic encephalopathy (2.5%), convulsions (3.5%), skull fractures (0.6%), intraventricular haemorrhage (0.2%), subdural haemorrhage (0.5%) and stroke (0.2%).

A substantial number of CH cases had a delayed diagnosis. A minority displayed symptoms of serious head trauma. CH was associated with intracranial haemorrhage.