Positional Skull Deformities and Neurodevelopmental Delay: Study on 449 Infants

Objective: Provide data on a cross-sectional study of neurodevelopmental delays (NDD) in patients with positional skull deformities (PSD), based on severity and gender, in early childhood. Methods: Neurodevelopment of 449 patients with PSD, with an age range of 3 to 59 months, was assessed with Battelle Developmental Inventory (BDI) tests during and after their cranial orthotic treatment. Data obtained were compared with the anthropometric measurements taken the same day the test was made, and results were grouped by diagnosis and severity, segmented by age group, and split by gender. Results: From 3983 patients with PSD and simple craniosynostosis, 526 accepted to participate and took a total of 1261 BDI tests. Premature patients, patients with neurological diseases or congenital malformations, and tests taken when PSD had been corrected were excluded. The resulting study group was 449 children (123 girls and 326 boys) and 972 BDI tests. Ninety-five percent of tests presented significant NDD (median value, expressed in months) in one or more BDI domains; male patients present larger NDD than do female patients; largest delays were found in brachycephaly and plagiocephaly combined (−7 mo at age range 48–59 mo), scaphocephaly (−3.5 mo at age range 12–17 mo), plagiocephaly (−3.2 mo at age range 12–17 mo). No significant NDD were found in the receptive or cognitive domains. Conclusion: When evaluating PSD, BDI tests, or similar, as well as mixed PSD classification should be considered. Patients with PSD should be monitored by a coordinated set of medical specialists.