Nonsynostotic plagiocephaly: A child health care intervention in Skaraborg, Sweden

Abstract

Background: The aim was to evaluate the intervention's effect on prevention and reversal of nonsynostotic plagiocephaly. Methods: Thirty-eight intervention group nurses were educated about nonsynostotic plagiocephaly and asked to follow guidelines; 18 control group nurses were not. In a longitudinal single-blinded clinical intervention, parents brought infants to well-child visits according to the national schedule. Cranial shape was assessed in 176 intervention and 92 control group infants at 2-, 4-, and 12-month visits. Results: Asymmetry at two months reversed by four months four times more often in intervention than control subgroup infants (OR = 4.07, p = 0.02) when adjusted for parent awareness of written information from their nurse. Asymmetry at two months reversed by 12 months fivefold when parents were aware of written information (OR = 0.19, p = 0.04). The risk for persistent asymmetry at 12 months was lower for intervention than control group infants (RR = 0.35, p = 0.03). Of infants with no asymmetry at two months, 25% in intervention and 22% in control group developed brachycephaly. Conclusions: The intervention contributed to early reversal and reducing infants' risk for persistent asymmetry. Parents' awareness of written information contributed to reversal. Preventing brachycephaly was difficult. Further research is needed.