Multiple-birth infants at higher risk for development of deformational plagiocephaly

Objective. Deformational plagiocephaly refers to the development of an abno rmal head shape in infants resulting from externally applied molding forces , which may occur either prenatally or postnatally. We have observed that a n unexpectedly high number of multiple-birth infants have presented to our center with this condition. The purposes of this investigation were to: 1) determine the significance of this observation; and 2) examine the risk fac tors that may make this population more susceptible to the development of p lagiocephaly. Materials and Methods. A retrospective review of our database was performed to identify those infants who were of multiple-birth origin. The parents o f these infants were contacted by phone to complete a survey regarding the prenatal and postnatal history of their child. Similar information was obta ined for the state of Arizona from the Office of Vital Statistics. A chi(2) analysis was used to compare the incidence of multiple births in Arizona w ith the incidence of multiple births in our treatment population. Results. Between 1993 and 1996, 69 (8.6%) of the 801 infants treated for de formational plagiocephaly at our Phoenix center were of multiple-birth orig in. Four infants who had been treated postoperatively after surgery for cra niosynostosis, as well as 5 patients who had been referred from out of stat e, were excluded from further study. The chi(2) analysis of the remaining 6 0 patients confirmed that a statistically significant number of plural-birt h infants had presented with deformational plagiocephaly. Four risk factors were identified as having occurred at high frequency in this population: i n utero constraint, supine sleeping position, torticollis, and prematurity. Conclusions. The current findings of this investigation confirm that a sign ificant number of multiple-birth infants have presented to our clinic with deformational plagiocephaly. Compared with their singleton counterparts, pl ural infants seem to be at higher risk for the development oi: deformationa l plagiocephaly, because they are more likely to be exposed to multiple ris k factors.