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Release: Jan. 7, 2002

NOTE TO EDITORS: Pediatrics, the journal of the American Academy of Pediatrics, contributed to this news release.

UI researcher participates in study on positional plagiocephaly

IOWA CITY, Iowa -- Research conducted by an investigator in the University of Iowa College of Public Health found that a twin infant who is in the lower part of the uterus during development is more likely to develop positional plagiocephaly -- a condition where the soft bones in a baby's skull become flattened or misshapen due to continual external pressure.

The study results are reported in the January 2002 issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics.

Although an increase in plagiocephaly has been tied to the American Academy of Pediatrics' 1992 recommendation to place infants to sleep on their back to reduce the risk of sudden infant death syndrome, a confined space while in utero also plays a significant role, the researchers found. The study, which examined detailed medical histories of 140 sets of twins identified from nine U.S. treatment centers, also found the lower-placed infant at higher risk for neck dysfunction.

"This study emphasizes the importance of in utero conditions as well as the interactions among in utero and postnatal events," said Kevin M. Kelly, Ph.D., research scientist in the UI department of occupational and environmental health and adjunct associate professor in the UI department of community and behavioral health and the UI department of anthropology. "While it is easy to understand how crowded in utero positioning might lead to neck dysfunction and consequently to plagiocephaly, it is important to recognize the role of postnatal infant positioning. Prolonged time in car seats and infant carriers and extended time lying on the back could exacerbate the problem."

When diagnosed during the first several months of life, simple activities such as repositioning the baby's head, adult-supervised "tummy time" and physical therapy can have a significant impact in improving and correcting plagiocephaly. In rare cases where a severe, persistent deformity persists, reconstructive surgery may be required.

This study is the most recent in a series of collaborative research studies addressing the etiology, prevention and treatment of positional plagiocephaly. Other investigators included Timothy R. Littlefield and Jeanne K. Pomatto, both of Cranial Technologies, Inc. in Phoenix, Ariz., and Stephen P. Beals, M.D., of the Southwest Craniofacial Center in Phoenix, Ariz.