Mosca-Hayler Alexandra, López-Schmidt Daniela, Curotto-Noce Romina, Cuevas-Aburto Jorge, Vásquez-Gómez Jaime, Durán-Agüero Samuel, Borja González Juana, Diaz-Martínez Ximena, Zapata-Lamana Rafael, Parra-Rizo María Antonia, Cigarroa Igor
Escuela de Kinesiología, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile.
Centro de Aprendizaje, Universidad Santo Tomás, Los Ángeles 4440000, Chile.
Children (Basel). 2024 Mar 4;11(3):302. doi: 10.3390/children11030302.
Positional cranial deformities are associated with prematurity evolving during the first 2 years of life due to the malleable characteristics of the skull, the first year being the main/primary therapeutic window for intervention. The objectives were (a) to describe health characteristics, peri- and postnatal pathologies, and positional cranial deformities in infants enrolled in an early intervention program and (b) to analyze the effects of a parent education-based intervention program on positional cranial deformity in premature infants. A quantitative, analytical, longitudinal study was conducted. It included 103 premature infants enrolled in an early intervention program (EIP) during the year 2017, all under 4 months of corrected age, to whom a parent education-based intervention program was applied. Cranial circumference, cranial width, diagonals, and anteroposterior diameter were measured, and the cranial asymmetry index (CAI) and cephalic index (CI) were calculated at baseline and during two subsequent evaluations separated by a 3-month period. The main results showed that 75.7% of the infants belonged to a very premature gestational age category, and 57.3% had an adequate weight for gestational age. The most frequent pathologies were premature jaundice, premature anemia, and hyaline membrane disease. The most frequent positional cranial deformity was plagiocephaly. The parent education-based intervention program resulted in (1) a significant decrease in the CAI and a significant increase in the IC, (2) plagiocephalies: an increase in the mild category and a decrease in the moderate + severe categories, (3) brachycephalies: a decrease in the absence category and an increase in the moderate + severe category, and (4) dolichocephalies: an increase in the absence category and a decrease in the mild category. In conclusion, the recommended first line of intervention was not enough for this population, and future studies should support the development of national clinical guidelines, where education is complemented with other therapeutic measures.
由于颅骨具有可塑性，在生命的头两年中，体位性颅骨畸形与早产有关，第一年是主要的/首要的干预治疗窗口。研究目的是：(a) 描述参加早期干预项目的婴儿的健康特征、围产期和产后病理情况以及体位性颅骨畸形情况；(b) 分析基于家长教育的干预项目对早产儿体位性颅骨畸形的影响。开展了一项定量、分析性纵向研究。研究纳入了2017年参加早期干预项目（EIP）的103名早产儿，所有婴儿矫正年龄均在4个月以下，并对其实施了基于家长教育的干预项目。测量了头围、颅宽、对角线和前后径，并在基线期以及随后间隔3个月的两次评估中计算了颅骨不对称指数（CAI）和头指数（CI）。主要结果显示，75.7%的婴儿属于极早产孕周类别，57.3%的婴儿出生体重与孕周相称。最常见的病理情况是早产黄疸、早产贫血和透明膜病。最常见的体位性颅骨畸形是斜头畸形。基于家长教育的干预项目导致：(1) CAI显著降低，IC显著升高；(2) 斜头畸形：轻度类别增加，中度+重度类别减少；(3) 短头畸形：无畸形类别减少，中度+重度类别增加；(4) 长头畸形：无畸形类别增加，轻度类别减少。总之，对于该人群而言，推荐的一线干预措施并不足够，未来的研究应支持制定国家临床指南，将教育与其他治疗措施相结合。
