Seattle Children's Hospital, 4800 Sand Point Way, N.E., Mailstop W-3636, Seattle, WA 98105, USA.
Pediatrics. 2010 Mar;125(3):e537-42. doi: 10.1542/peds.2009-0052. Epub 2010 Feb 15.
We assessed the neurodevelopment of infants with and without deformational plagiocephaly (DP), at an average age of 6 months.
The Bayley Scales of Infant Development III (BSID-III) were administered to 235 case subjects and 237 demographically similar, control participants. Three-dimensional head photographs were randomized and rated for severity of deformation by 2 craniofacial dysmorphologists who were blinded to case status.
We excluded 2 case subjects with no photographic evidence of DP and 70 control subjects who were judged to have some degree of DP. With control for age, gender, and socioeconomic status, case subjects performed worse than control subjects on all BSID-III scales and subscales. Case subjects' average scores on the motor composite scale were approximately 10 points lower than control subjects' average scores (P < .001). Differences for the cognitive and language composite scales were approximately 5 points, on average (P < .001 for both scales). In subscale analyses, case subjects' gross-motor deficits were greater than their fine-motor deficits. Among case subjects, there was no association between BSID-III performance and the presence of torticollis or infant age at diagnosis.
DP seems to be associated with early neurodevelopmental disadvantage, which is most evident in motor functions. After follow-up evaluations of this cohort at 18 and 36 months, we will assess the stability of this finding. These data do not necessarily imply that DP causes neurodevelopmental delay; they indicate only that DP is a marker of elevated risk for delays. Pediatricians should monitor closely the development of infants with this condition.
我们评估了患有和不患有变形性斜头畸形（DP）的婴儿的神经发育情况，平均年龄为 6 个月。
对 235 例病例组和 237 名具有相似人口统计学特征的对照组进行贝利婴幼儿发展量表第三版（BSID-III）测试。将三维头部照片随机分配给 2 名颅面畸形学家进行严重程度评分，这 2 名颅面畸形学家对病例状态不知情。
我们排除了 2 名没有 DP 照片证据的病例组和 70 名被认为存在一定程度 DP 的对照组。在控制年龄、性别和社会经济地位的情况下，病例组在所有 BSID-III 量表和子量表上的表现均不如对照组。病例组运动综合量表的平均得分比对照组低约 10 分（P <.001）。认知和语言综合量表的差异平均约为 5 分（两个量表均 P <.001）。在子量表分析中，病例组的粗大运动缺陷大于精细运动缺陷。在病例组中，BSID-III 表现与斜颈的存在或婴儿的诊断年龄之间没有关联。
DP 似乎与早期神经发育障碍有关，这在运动功能中最为明显。在对该队列进行 18 个月和 36 个月的随访评估后，我们将评估这一发现的稳定性。这些数据并不一定意味着 DP 导致神经发育迟缓；它们仅表明 DP 是发育迟缓风险升高的标志物。儿科医生应密切监测患有这种情况的婴儿的发育情况。
