JMIR Publications

ABSTRACT

Background:

Plagiocephaly is defined as asymmetrical distortion of the skull resulting in an oblique trapezoid or parallelogram head shape. Deformational plagiocephaly (DP) is caused by forces acting on one side of the back of the head which distorts the normal symmetry of the skull.

Objective:

The aims of this systematic review and meta-analysis were to critically assess the evidence for non-obstetric risk factors for DP and to make evidence-based recommendations for reducing the prevalence of DP.

Methods:

A search of PubMed and Web of Science was performed covering 21 August 2010 to 21 August 2022. The searches yielded 159 articles, of which 18 articles were eligible for inclusion.

Results:

Forty-three potential non-obstetric factors were identified. Of these, 16 were significantly associated with DP. Twelve had significant odds ratios: Insufficient vitamin D intake (OR, 7.15; 95% CI 3.77–13.54), head position preference (OR, 4.75; 95% CI 3.36–6.73), bottle only feeding (OR, 4.65; 95% CI 2.70–8.00), reduced tummy time (OR, 3.51; 95% CI 1.71–7.21), sleeping position (OR, 3.12; 95% CI 2.21–4.39), fewer motor milestones by six months of age (OR, 2.56; 95% CI 1.66–3.96), obesity (OR, 2.45; 95% CI 1.02–5.90), maternal education level (OR, 1.66; 95% CI 1.17–2.37), male gender (OR, 1.51; 95% CI 1.07–2.12), formula feeding (OR, 1.51; 95% CI 1.00–2.27), head circumference (OR, 1.22; 95% CI 1.06–1.40), and mechanical ventilation (OR, 1.10; 95% CI 1.00–1.14).No evidence of publication bias was detected.

Conclusions:

In summary, this study provides a comprehensive meta-analytic assessment of non-obstetric factors associated with DP. It provides 12 evidence-based recommendations aimed at reducing the prevalence of DP.