gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Risk factors for deformational plagiocephaly: A case-control study

Meeting Abstract

  • N.O. Schmidt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • E. Probsthein - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • A. Treszl - Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf
  • M. Westphal - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • J. Regelsberger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.08.03

DOI: 10.3205/11dgnc159, URN: urn:nbn:de:0183-11dgnc1593

Veröffentlicht: 28. April 2011

© 2011 Schmidt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Deformational plagiocephaly in infants is a common and increasing problem. The objective of this study was to identify risk factors influencing the development of nonsynostotic plagiocephaly.

Methods: We conducted a case-control study and included infants with nonsynostotic plagiocephaly of our outpatient clinic during the period from 2003 to 2006 (n=109). Healthy controls were randomly selected by referring centers (n=50). Information concerning obstetric factors, infant factors and infant care practice was obtained by a parental answered standardized questionnaire containing 27 items. Data was statistically analysed including univariate and multivariate logistic regression analyses.

Results: Case and control groups were comparable with regard to age (mean 13 months) and gender with a slight but non-significant male predominance in the case group. Infants with deformational plagiocephaly were more likely to have been firstborn than healthy controls (OR:1.4; 95% CI:0.66–2.86), premature (<37 weeks) or to have had an unusual intrauterine position (OR:8.4; 95% CI:1.09–65.46) and headshape (OR:4.4; 95% CI:1.26–15.47) during delivery. However, the type of delivery including forceps- or ventouse-assisted deliveries was not predictive for the development of plagiocephaly as has been suggested in previous studies. Cases were more likely to have been limited in their ability to rotate the head (OR:35.4; 95% CI:8.16–153.74) while also having a preferential head orientation during sleep (OR:9.8; 95% CI:4.49–21.25). Tummy time in the first weeks after birth were significantly lower in the case group (mean 34 min/d versus 143 min/d) while variables of the composition of mattress and pillow had no influence on the development of plagiocephaly. More parents of cases reported a developmental delay (p<0.05) and their children as less active (p<0.01). Analyses at a multivariate level revealed that factors influencing the head mobility such as time at supine position (aOR:1.2; 95% CI:1.07–1.26) or neck muscle dysfunction (aOR:16.1; 95% CI:3.01–85.89) are significantly correlated with the development of plagiocephaly.

Conclusions: Our study reinforces the hypothesis that specific nursing habits and positional preferences in combination with impaired head motility are highly associated with the development of deformational plagiocephaly. Therefore, early identification of these risk factors may help to prevent and guide the management of infants with deformational plagiocephaly.