目的 探讨3~18个月婴幼儿头颅畸形的头颅形态特征及影响因素,为婴幼儿头颅畸形的预防和干预提供指导和依据。方法 于2022年1月选取2019年1—12月在南京市妇幼保健院健康体检时诊断为头颅畸形的228名婴幼儿为病例组,并选取同期健康体检的性别、年龄匹配的394名头颅形态正常婴幼儿为对照组。分析病例组婴幼儿头颅形态特征,并通过比较两组间基本信息、母亲孕产史、睡眠姿势、骨密度等差异分析头颅畸形的影响因素。结果 1)3~18个月头颅畸形患儿头颅形态特征:头颅畸形组中男性占比高于女性;6月±7 d的占比最高,之后随着年龄的增长,头颅畸形占比呈下降趋势;短头畸形的检出率最高,且不同类型头颅畸形在年龄(χ2=34.409)和严重程度(χ2=11.404)之间差异有统计学意义(P<0.05)。2)单因素分析结果显示:头颅畸形组和正常组在单/双胎(χ2=4.724)、新生儿期头部损伤史(χ2=8.430)、睡眠姿势(χ2=23.881)和骨密度(t=2.771)之间差异有统计学意义(P<0.05)。3)多因素Logistic回归分析显示,年龄(以3月±7 d组为参照,6月±7 d组OR=3.720,95%CI:1.959~7.066,P<0.05;8月±7 d组OR=3.181,95%CI:1.449~6.984,P<0.05;12月±7 d组OR=3.195,95%CI:1.281~7.966,P<0.05)、双胎(OR=3.950,95%CI:1.227~12.717,P<0.05)是头颅畸形的危险因素、混合睡姿(OR=0.209,95%CI:0.129~0.338,P<0.05)和骨密度(OR=0.763,95%CI:0.636~0.917,P<0.05)是婴幼儿头颅畸形的保护因素。结论 年龄、双胎、睡眠姿势以及骨密度是婴幼儿头颅畸形的重要影响因素,随着婴幼儿年龄的增长,头颅畸形可能有所改善,仍需进一步的纵向研究去验证婴幼儿头颅畸形的影响因素。
Abstract
Objective To investigate the cranial morphological characteristics and influencing factors of plagiocephaly in infants and children aged 3 to 18 months, so as to provide guidance and basis for the prevention and intervention of cranial anomalies in infants and children. Methods A total of 228 infants with plagiocephaly determined during physical examination in Nanjing Maternal and Child Health Hospital from January to December 2019 were selected as the case group, and 394 infants with normal skull shape were selected as the control group. Gender and age were matched between the two groups. The clinical characteristics of the case group were analyzed, and the influencing factors of plagiocephaly were analyzed by comparing the differences of basic information, maternal pregnancy and childbirth history, sleep posture and bone mineral density between the two groups. Results 1) The proportion of males in plagiocephaly group was higher than that of females. In term of age, the proportion of plagiocephaly in infants aged 6 months ± 7 days was the highest, then the proportion of plagiocephaly decreased with the increase of age. The detection rate of brachycephaly was the highest, and statistically significant difference in the type of cephalic malformations was found among different age (χ2=34.409) and severity(χ2=11.404) groups(P<0.05). 2) Univariate analysis showed that there were statistical differences in single/twin (χ2= 4.724), neonatal head injury history (χ2=8.430), sleep posture (χ2=23.881) and bone mineral density (t=2.771) between case group and control group (P<0.05). 3) Multivariate Logistic regression analysis showed that age(taking 3 months ± 7 days group as the reference, 6 months ± 7 days group OR=3.720, 95%CI:1.959 - 7.16, P<0.05; 8 months ± 7 days group OR =3.181, 95%CI:1.449 - 6.984, P<0.05; 12 months ± 7 days group OR=3.195, 95%CI:1.281 - 7.966, P <0.05) and twins (OR=3.950, 95%CI:1.227 - 12.717, P<0.05) were risk factors for plagiocephaly, while mixed sleeping posture (OR=0.209, 95%CI:0.129 - 0.338, P<0.05) and bone mineral density (OR=0.763, 95% CI:0.636 - 0.917, P<0.05) were protective factors of infant plagiocephaly. Conclusions Age, twins, sleep posture and bone density are important influencing factors of infant plagiocephaly. With the growth of infant age, the plagiocephaly may be improved, and further longitudinal research is still needed to verify the influencing factors of infant plagiocephaly.
关键词
婴幼儿 /
头颅畸形 /
头颅形态
Key words
infant /
plagiocephaly /
cranial morphology
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参考文献
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