Investigation Into an Increase in Plagiocephaly in Texas From 1999 to 2007

Sheu, Shane; Ethen, Mary K.; Scheuerle, Angela E.; Langlois, Peter H.

doi:10.1001/archpediatrics.2011.42

Cited by 12 publications

(16 citation statements)

References 20 publications

(22 reference statements)

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“…A second approach to distinguish true trends from artifactual was to eliminate from the total birth defects cases the large number with atrial septal defect, ventricular septal defect, patent ductus arteriosus, or plagiocephaly: all reported to be highly susceptible to diagnostic variation Langlois et al, 2010;Sheu et al, 2011), and thus likely to exhibit artifactual time trends as more sensitive diagnostic tests or equipment are routinely used or more referral to specialists occurs. The increasing trend in total defects went from 3.6% to 2.8% per year.…”

Section: Discussionmentioning

confidence: 99%

Time trends in the prevalence of birth defects in Texas 1999-2007: Real or artifactual?

Langlois

Marengo

Canfield

2011

Birth Defects Research Part A: Clinical and Molecular Teratolog

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In our opinion, the weight of evidence in our study suggests that the observed increase over time in total birth defects and in many specific birth defects is artifactual. This likely reflects increased awareness, referral, detection, or documentation in health care facilities visited by TBDR staff, resulting in more complete ascertainment by the registry, rather than a true change over time in the occurrence of most birth defects.

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Section: Discussionmentioning

confidence: 99%

Time trends in the prevalence of birth defects in Texas 1999-2007: Real or artifactual?

Langlois

Marengo

Canfield

2011

Birth Defects Research Part A: Clinical and Molecular Teratolog

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“…3,6,23,39,51 Some reports have pointed to poor knowledge and awareness of the condition in parents with lower education levels. 9,60,68 There is also a question of whether some parents may be refusing recommendations because of misconceptions. 10,17,68 Another study investigated the rise in PP incidence in the state of Texas for a significant number of years following the 1992 recommendation and found that it was mainly attributed to an increase in the number of referrals, although the reason for that increase could only be speculated upon.…”

Section: Socioeconomic and Environmental Considerationsmentioning

confidence: 99%

“…10,17,68 Another study investigated the rise in PP incidence in the state of Texas for a significant number of years following the 1992 recommendation and found that it was mainly attributed to an increase in the number of referrals, although the reason for that increase could only be speculated upon. 60 Last, the publicity about the condition and marketing of its treatments, particularly cranial orthoses, cannot be denied. 54 …”

Section: Socioeconomic and Environmental Considerationsmentioning

confidence: 99%

“…23,39 Furthermore, it is imperative to compare an infant's head shape to that of his/her parents and to factor in the role of heredity along with environment during assessment. 51 Sheu et al 60 explored aspects involved in the 9-fold increase in plagiocephaly in Texas between 1999 and 2007. The prevalence of PP had increased an average of 21.2% per year, resulting in an incidence of 28.8 cases per 10,000 live births (up from 3 cases per 10,000 live births in 1999).…”

Section: Cultural Backgrounds and Practices Can Influencementioning

confidence: 99%

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Positional plagiocephaly: an analysis of the literature on the effectiveness of current guidelines

Shweikeh

Nuño

Danielpour

et al. 2013

FOC

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Object Positional plagiocephaly (PP) has been on the rise in recent years. In this review, the authors' aim was to assess the effectiveness of current recommendations to parents on this exceedingly common problem through a comprehensive literature search. Additionally, the current treatment options and the most recent studies on PP are reviewed. Methods A search of the existing literature was conducted to obtain all relevant studies on guidelines, recommendations, parental and clinician practices, and epidemiological aspects. Results Although the incidence and risk factors for PP have been well delineated, there continues to be debates on its management and association with developmental delays. Current guidelines and recommendations on prevention set by the American Association of Pediatrics may not be easily followed by both parents and clinicians. There is also evidence that certain populations, including those with lower education, socioeconomic status, and in particular geographic regions may be more affected by the condition. Additionally, the marketing and financial aspects of PP treatments exist and should be addressed. Conclusions Better awareness and education are necessary to inform the population as a whole, although certain populations should be given special attention. Additionally, current guidelines and recommendations can be modified to foster a better grasp of the condition by both parents and clinicians. Adjusting current recommendations, introducing initiatives, and offering elaborate educational campaigns would help deliver these aims. Educating parents on PP as early as possible through clearer guidelines and close monitoring is central to preventing and managing this common condition.

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“…he institution of the Back to Sleep Campaign in 1992 has significantly decreased infant mortality due to sudden infant death syndrome (SIDS), while the prevalence of positional skull deformity has increased substantially. 11,12 Positional plagiocephaly and brachycephaly are the most common deformities. Occipital plagiocephaly is characterized by an increased oblique diagonal difference with noticeable asymmetrical flattening of the occiput.…”

mentioning

confidence: 99%

The health belief model and factors associated with adherence to treatment recommendations for positional plagiocephaly

Lam

Luerssen

Hadley

et al. 2017

PED

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OBJECTIVE This study aimed to examine factors associated with adherence to recommended treatment among pediatric patients with positional skull deformity by reviewing a single-institution experience (2007–2014) with the treatment of positional plagiocephaly. METHODS A retrospective chart review was conducted. Risk factors, treatment for positional head shape deformity, and parent-reported adherence were recorded. Univariate and multivariate analyses were used to assess the impact of patient clinical and demographic characteristics on adherence. RESULTS A total of 991 patients under age 12 months were evaluated for positional skull deformity at the Texas Children's Hospital Cranial Deformity Clinic between 2007 and 2014. According to an age- and risk factor–based treatment algorithm, patients were recommended for repositioning, physical therapy, or cranial orthosis therapy or crossover from repositioning/physical therapy into cranial orthosis therapy. The patients' average chronological age at presentation was 6.2 months; 69.3% were male. The majority were white (40.7%) or Hispanic (32.6%); 38.7% had commercial insurance and 37.9% had Medicaid. The most common initial recommended treatment was repositioning or physical therapy; 85.7% of patients were adherent to the initial recommended treatment. Univariate analysis showed differences in adherence rates among subgroups. Children's families with Medicaid were less likely to be adherent to treatment recommendations (adherence rate, 80.2%). Families with commercial insurance were more likely to be adherent to the recommended treatment (89.6%). Multivariate logistic regression confirmed that factors associated with parent-reported adherence to recommended treatment included primary insurance payer, diagnosis (plagiocephaly vs brachycephaly), and the nature of the recommended treatment. Families were less likely to be adherent if they had Medicaid, a child with a diagnosis of brachycephaly, or were initially recommended for cranial orthosis therapy than families with commercial insurance, a child with a diagnosis of plagiocephaly, or an initial recommendation for repositioning or physical therapy. Factors associated with treatment completion included corrected age, insurance, diagnosis, recommended treatment, and distance to provider from patient's residence. Patients with commercial insurance (OR 1.49, 95% CI 1.10–2.02, p = 0.009), those diagnosed with both brachycephaly and plagiocephaly (OR 2.26, 95% CI 1.31–3.90, p = 0.003), those recommended for treatment with cranial orthosis (OR 4.55, 95% CI = 3.24–6.38, p < 0.001), and those living in proximity to the provider (OR 1.40, 95% CI 1.00–1.96, p = 0.047) were more likely to complete treatment. CONCLUSIONS Insurance type, degree of head shape deformity, and types of recommended treatment appear to affect rates of adherence to recommended treatments for positional skull deformation.

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Investigation Into an Increase in Plagiocephaly in Texas From 1999 to 2007

Cited by 12 publications

References 20 publications

Time trends in the prevalence of birth defects in Texas 1999-2007: Real or artifactual?

Time trends in the prevalence of birth defects in Texas 1999-2007: Real or artifactual?

Positional plagiocephaly: an analysis of the literature on the effectiveness of current guidelines

The health belief model and factors associated with adherence to treatment recommendations for positional plagiocephaly

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