Prevalence and predictors of idiopathic asymmetry in infants born preterm

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• 作者：Jacqueline Nuysink^a ; ^{j.nuysink@umcutrecht.nl} ; Ingrid C. van Haastert^b ; Maria J.C. Eijsermans^a ; Corine Koopman-Esseboom^b ; Janjaap van der Net^a ; Linda S. de Vries^b ; Paul J.M. Helders^a
• 关键词：DP ; Deformational Plagiocephaly ; TEA ; Term-equivalent age ; GA ; Gestational age ; CA ; Corrected age ; BW ; Birth weight ; AIMS ; Alberta Infant Motor Scale
• 刊名：Early Human Development
• 出版年：2012
• 期刊代码：82_03783782
• 类别：med
• 出版时间：June, 2012
• 卷：88
• 期：6
• 页码：387-392
• 文件大小：332 K

摘要

Background

An idiopathic asymmetry in posture of the head is recognized as a risk factor to develop a deformational plagiocephaly (DP). In our neonatal follow-up clinic, an IA is often observed in infants born preterm at term-equivalent age (TEA).

Aims

To explore (1) the prevalence of an idiopathic asymmetry in 192 infants (gestational age 鈮?#xA0;32.0 weeks) at TEA and 6 months corrected age (CA), (2) whether demographical, perinatal, and medical factors were predictors of the asymmetry, and (3) differences in motor maturation between infants with and without asymmetry.

Methods

In a retrospective study, frequencies of idiopathic asymmetry and DP, putative predictors, and Alberta Infant Motor Scale scores at 6 months CA were abstracted and analyzed with Chi², Mann-Whitney, logistic regression and T-test.

Results

The prevalence rate of a positional preference of the head at TEA was 44.8%(n = 86), 10.4%(20/192) had a DP at TEA and 13%(25/192) at 6 months CA. Positional preference, multiple birth and male gender predicted the presence of DP (p < .05, odds ratio 3.0, 3.2, and 3.1 respectively). Gross motor maturity at 6 months CA was less developed in infants with a positional preference at TEA compared to preterm norms (p = 0.01).

Conclusions

The high prevalence of a positional preference in infants born preterm at term equivalent age requires extra alertness to prevent the development of a deformational plagiocephaly, especially in boys and twins. Although, considering the lower prevalence of plagiocephaly at 6 months CA, therapists should be aware of over treating these infants.