Change in Head Shape of Newborn Infants in the Week following Birth: Contributing Factors

The aim of this work is to assess the influence of design factors: continuous numerical variables (age at first measurement, time lapse, and birth weight) and nominal categorical variables (sex of neonate, delivery outcome) on the neonatal head shape change. Sixty newborns were included in this study and 13 cephalometric variables were measured. Multiple linear regressions with change from baseline were performed. Country of birth of the mothers, centile scale of birth weight, and degree of flexion were used in a descriptive analysis. The suboccipitobregmatic difference is significantly correlated with the age at the first measurement (B = 0.058; p = 0.008). Only two cephalometric variables are correlated with the time lapse between measurements: the bitragion difference (B = –0.042; p = 0.039) and the head circumference (B = 0.056; p = 0.047). The biparietal difference is significantly correlated with the birth weight (B = –0.001; p = 0.038), and the mentovertical difference is significantly correlated with the sex “female” (B = 2.764; p = 0.025). Concerning the delivery outcomes, the suboccipitofrontal difference is significantly correlated with the cesarean section (B = 2.455; p = 0.012), and the occipitofrontal difference is significantly correlated with the Thierry's spatula extraction (B = 2.097; p = 0.048). Results suggest that instrumental extractions may have an important impact on neonatal head shape change. When operative intervention in the second stage of labor is required, the options, risks, and benefits of vacuum and forceps must be considered given the possible neonatal complications (cephalohematomas, retinal hemorrhages, external ocular injuries, facial nerve palsies).