Prevailing head position to one side in early infancy - a population-based study

Straathof, E. J. M., Heineman, K. R., Hamer, E. G. & Hadders-Algra, M., Jul-2020, In : Acta Paediatrica. 109, 7, p. 1423-1429 7 p.

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Aim: To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio-economic factors. Methods: Observational study in 500 infants (273 boys) 2-6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27-42); birthweight 3438 g (1120-4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio-economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni- and multivariable statistics. Results: Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4-5 months PHP was significantly associated with worse reaching and an at-risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post-natal admission to a paediatric ward and paternal native Dutch background. Conclusion: Prevailing head position to one side at 2-3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4-5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4-5 months could serve as a red flag indicating possible challenges in later development.

Original languageEnglish
Pages (from-to)1423-1429
Number of pages7
JournalActa Paediatrica
Issue number7
Early online date29-Nov-2019
Publication statusPublished - Jul-2020


  • infancy, motor development, neurological condition, perinatal risk, prevailing head position, 1ST 2 YEARS, POSTURAL CONTROL

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