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Age-dependent changes in infant head shape: a smartphone app-based study in Japan.

Satoshi Narumi1, Yui Honda2, Yoriko Kotoku2

  • 1Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.

Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology
|April 2, 2026
PubMed
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This study establishes reference curves for infant head shape in Japan. Cranial vault asymmetry peaks at 3-4 months, while head proportionality increases until 6 months, with sex-based differences noted.

Area of Science:

  • Pediatrics
  • Anthropology
  • Biometrics

Background:

  • Infant head shape changes rapidly, but age-dependent cranial asymmetry is not well understood.
  • Characterizing normal head shape development is crucial for identifying potential health issues.

Purpose of the Study:

  • To analyze factors influencing head shape parameters in Japanese infants.
  • To establish normative reference curves for cranial vault asymmetry index (CVAI) and cranial index (CI) in Japanese infants.

Main Methods:

  • Collected head shape data (CVAI and CI) from 127,605 Japanese infants using a smartphone app.
  • Performed univariate and multivariate analyses to identify associated factors.
  • Constructed reference curves using data from 72,726 infants born via spontaneous vaginal delivery with normal birth weight.
Keywords:
head shapeinfantlow birth weight infantpositional cranial deformitysmartphone app

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Main Results:

  • CVAI peaked at 3-4 months and then declined; CI increased until approximately 6 months.
  • Boys exhibited significantly higher CVAI than girls.
  • Low birth weight was associated with lower CI.

Conclusions:

  • This study provides the first reference curves for CVAI and CI specific to Japanese infants.
  • The findings illustrate the natural progression of cranial asymmetry and proportionality during infancy.
  • Age-specific assessment is vital for interpreting head shape parameters.