Dolichocephaly in Preterm Infants: Prevalence, Risk Factors, and Early Motor Outcomes

Dana B. McCarty; Jennifer R. Peat; William F. Malcolm; P. Brian Smith; Kimberley Fisher; Ricki F. Goldstein

doi:10.1055/s-0036-1592128

American Journal of Perinatology, Table of Contents

Am J Perinatol 2017; 34(4): 372-378
DOI: 10.1055/s-0036-1592128

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dolichocephaly in Preterm Infants: Prevalence, Risk Factors, and Early Motor Outcomes

Authors

Dana B. McCarty

¹Division of Physical Therapy, Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Jennifer R. Peat

²Department of Physical and Occupational Therapy, Duke University Medical Center, Durham, North Carolina
William F. Malcolm

³Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
P. Brian Smith

⁴Department of Pediatrics, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina
Kimberley Fisher

³Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
Ricki F. Goldstein

³Division of Neonatology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina

Abstract

Objective The purpose of this study was to determine when dolichocephaly develops in preterm infants, to establish factors that contribute to its development, and to determine its association with adverse motor outcomes.

Study Design This study was a retrospective review of data collected from preterm infants born at < 32 weeks' gestation. The cranial index was measured by a physical therapist (PT) at three time points during hospitalization. Demographic data, neonatal morbidities, and motor outcomes at outpatient follow-up were collected.

Results Overall, 54% of infants developed dolichocephaly during hospitalization. The presence of dolichocephaly was highest in infants between 32 and 34 weeks' postmenstrual age (PMA) (39%). Birth weight, gestational age, bronchopulmonary dysplasia, gastroesophageal reflux disease, and severe intraventricular hemorrhage were not associated with dolichocephaly. Infants with dolichocephaly at 32 to 34 weeks' PMA were more likely to either be receiving PT services or be referred to PT services by outpatient follow-up (p = 0.05).

Conclusion The presence of dolichocephaly was highest in infants between 32 and 34 weeks' PMA and was associated with increased need for PT services in early infancy. Findings support early developmental intervention at < 32 weeks' PMA to prevent and/or treat cranial molding deformity and improve early motor outcomes.

Keywords

dolichocephaly - preterm infants - developmental outcome - physical therapy - cranial molding - cranial index - motor outcomes - risk factors

Full Text

References

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