Stereophotogrammetric head shape assessment in neonates is feasible and can identify distinct differences between term-born and very preterm infants at term equivalent age

Abstract

The development of head shape and volume may reflect neurodevelopmental outcome and therefore is of paramount importance in neonatal care. Here, we compare head morphology in 25 very preterm infants with a birth weight of below 1500 g and / or a gestational age (GA) before 32 completed weeks to 25 term infants with a GA of 37–42 weeks at term equivalent age (TEA) and identify possible risk factors for non-synostotic head shape deformities. For three-dimensional head assessments, a portable stereophotogrammetric device was used. The most common and distinct head shape deformity in preterm infants was dolichocephaly. Severity of dolichocephaly correlated with GA and body weight at TEA but not with other factors such as neonatal morbidity, sex or total duration of respiratory support. Head circumference (HC) and cranial volume (CV) were not significantly different between the preterm and term infant group. Digitally measured HC and the CV significantly correlated even in infants with head shape deformities. Our study shows that stereophotogrammetric head assessment is feasible in all preterm and term infants and provides valuable information on volumetry and comprehensive head shape characteristics. In a small sample of preterm infants, body weight at TEA was identified as a specific risk factor for the development of dolichocephaly.

Direct Anthropometry Overestimates Cranial Asymmetry—3D Digital Photography Proves to Be a Reliable Alternative

“…With the development of advanced photogrammetry systems and software over the past years, a slight but significant superiority of 3D digital measurements over direct manual anthropometry could be determined [18,29,31,36]. That superiority is based on the more straightforward clinical applicability, the easier detection of landmarks without patient movements, repeatable measurements without patient discomfort, less dependence on the examiner, and better interrater reliability [29,[35][36][37].…”

“…Further, identifying risk factors predisposing neonates to plagiocephaly is critical [13,18]. Those include, among others, premature birth, a restrictive intrauterine environment, delivery by forceps or vacuum extraction, male gender, congenital muscular torticollis, and a supine sleeping position [4,5,12,17,18].…”

“…Further, identifying risk factors predisposing neonates to plagiocephaly is critical [13,18]. Those include, among others, premature birth, a restrictive intrauterine environment, delivery by forceps or vacuum extraction, male gender, congenital muscular torticollis, and a supine sleeping position [4,5,12,17,18]. Furthermore, nutrition during pregnancy and childhood could be identified as risk factors, as the inadequate consumption of vitamin D and folic acid was associated with cranial deformations in the infant [13].…”

Stereophotogrammetry can feasibly assess ‘physiological’ longitudinal three-dimensional head development of very preterm infants from birth to term

“…This could be a window of opportunity for potential preventive interventions, too. To address this, we recently described the feasibility and safety of 3D stereophotogrammetry for head assessment in neonatal patients during hospitalisation 11 , 12 .…”