Boere-Boonekamp, Magdalena M.

IJzerman, Maarten Joost

L'Hoir, Monique P.

van der Ploeg, Catharina P.B.

van Vlimmeren, Leo A.

van Wijk, Renske

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Skull deformation in infancy: risk factors and effectiveness of helmet therapy.

University of Twente Research Information

Association between skull deformation in infants and vitamin D deficiency during pregnancy and early childhood. Marieke G.M. Weernink*, Renske M. van Wijk*, Karin G.M. Groothuis-Oudshoorn*, Leo  A. van Vlimmeren**, Caren I. Lanting***, Magda M. Boere-Boonekamp* * Department Health Technology and Services Research, University of Twente, Enschede, The Netherlands,   ** Department of Rehabilitation, University Medical Centre St Radboud, Nijmegen, The Netherlands  ***TNO, Quality of Life, Leiden, The Netherlands Purpose - Skull deformation due to a positional preference can occur in infants because their cranium is malleable and growing fast especially in the first months of life. Since vitamin D is known to be important for the intestinal absorption of calcium and bone mineralisation, it has been suggested that vitamin D deficiency can increase the risk of skull deformation. This case-control study investigates the relationship between vitamin D intake in the third trimester of pregnancy (mother) and in the first months of life (infant) and skull deformation in 2-4 month old infants.  Material - 275 2-4 month old cases with mild to severe skull deformation from the Helmet Therapy Assessment in Deformed Skulls (HEADS) study were compared with 548 matched controls.  Methods - A questionnaire was used to collect information on background characteristics and vitamin D intake (food, time spent outdoors and supplementation).  Results – A multivariate model showed that 2-4 month old infants of mothers with an insufficient intake of vitamin D during the last trimester of pregnancy were 1,5 times more likely to have a skull deformation (aOR 1.5; 95% CI 1.1-2.1). The effect of insufficient vitamin D intake in early childhood (aOR 3.0; CI 0.89;10.0) was approaching significance (p=0.078). Other significant (p<0.05) risk factors were male gender, shorter pregnancy, delivery in hospital for medical reasons, younger age and low level of education of the mother.  Conclusions - Insufficient vitamin D intake in the third trimester of pregnancy was observed rather frequently. Vitamin D intake in newborns appears adequate in almost all children in The Netherlands (in 97.0% of the cases and 99.1% of controls). Our findings suggest that an insufficient vitamin D intake was associated with the risk of skull deformation in 2-4 month old infants. This supports the importance to promote a lifestyle with a sufficient vitamin D intake in pregnant women.     

English

https://ris.utwente.nl/ws/files/5451847/Abstract_R_M__van_Wijk_EUSUHM_2011_DEFINITIEF.pdf

Skull deformation in infancy: risk factors and effectiveness of helmet therapy.

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University of Twente Research Information