Effectiveness of a Prenatal Educational Intervention to Prevent Positional Occipital Plagiocephaly

NCT07182604 | Completed

• 1 other identifier: POP2019
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

Positional occipital plagiocephaly (POP) is a morphological abnormality of the cranium which, in the absence of early synostosis of the cranial sutures, is caused by external forces acting on the skull, which is highly malleable in newborns. The most common form of POP is the "acquired" type, which manifests around 2-3 months of age and reaches its peak severity around 4 months. The incidence of POP is 46.6% at 7-12 weeks of life, and 78.3% of cases are mild severity. In addition to being an aesthetic problem, POP can alter the first phase of a child's postural-motor development, causing postural asymmetries in the neck or spine, or asymmetries in the functional motor skills. Often, attention is only paid to the condition at a later stage, when the situation is very evident and often associated with other issues, resulting in longer, more expensive physiotherapy treatments and poorer outcomes. Recently, interest has emerged in the possibility of preventing POP: studies have been conducted showing that preventive and educational intervention with families on the most appropriate ways of caring for their babies after birth effectively reduces the incidence and severity of POP in the first months of life and that good nationwide training of healthcare professionals on this topic could help minimize public healthcare costs. The Specialist Interest Group (GIS) in Pediatric Physiotherapy of the AIFI Italian Association of Physiotherapists (AIFI) has produced a brochure for parents on the prevention of POP. Primary endpoint: to assess whether the educational intervention for the prevention of POP carried out by the physiotherapist, as part of the prenatal program, reduces the incidence of POP in infants at 3 months of age. Secondary endpoints: to assess whether the educational intervention is effective in preventing the problems often associated with POP (postural torticollis, muscle contracture in the neck, benign scoliosis, immaturity in axial control).

Conditions

Plagiocephaly, Positional

Keywords

plagiocephaly positional; prevention

Outcome Measures

Primary Outcomes (1)

• Difference in the ODDI index measured with a craniometer

  0,3 months post born

Secondary Outcomes (1)

• Difference in number of children affected by torticollis, benign scoliosis, axial immaturity in control group and intervention group

  0,3 months afther birth

Study Arms (2)

Experimental group

EXPERIMENTAL

Parents who received the educational program on POP prevention

Other: educational program on the POP prevention

Standard of care

NO INTERVENTION

Parents who do not received the educational program on POP prevention

Interventions

educational program on the POP prevention OTHER

During a regular prenatal class meeting, parents belonging to this group received information about POP and how to prevent it (a presentation by a physiotherapist, a video shown to all centers participating in the study, practical demonstrations of activities using a doll, and a brochure with prevention tips). The children were then assessed at birth to rule out congenital disorders and at 3 months to detect any POP and associated postural problems. They were then sent a questionnaire to assess their perceived quality of the educational intervention carried out by the physiotherapist during the prenatal course.

Experimental group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participation of parents in the prenatal course at 34-38 weeks of gestation;
• Signing of the informed consent form;

You may not qualify if:

• parents (mother or both) aged \< 18 years;
• foreign parents with difficulty in understanding the Italian language and therefore giving informed consent to the study.
• In addition, children who present the following conditions at birth has been excluded from the study:
• prematurity with gestational age \< 36 weeks;
• neonatal distress;
• congenital occipital plagiocephaly - with cranial asymmetry measurable using a craniometer and ODDI (cranial asymmetry index) \> 112.6%;
• clavicle fractures;
• congenital clubfoot, metatarsus varus;
• congenital spinal and pelvic abnormalities.

Sponsors & Collaborators

• Meyer Children's Hospital IRCCS: lead
• Azienda Ospedaliero-Universitaria Careggi: collaborator
• Azienda Ospedaliero-Universitaria di Parma: collaborator
• Ospedale Infermi Rimini: collaborator

Study Sites (1)

Viola Fortini

Florence, FI, 50139, Italy

Location

MeSH Terms

Conditions

Plagiocephaly, Nonsynostotic

Condition Hierarchy (Ancestors)

Plagiocephaly; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Musculoskeletal Diseases; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist

Model Details: Multicenter, randomized intervention study with a 1:1 ratio, with cluster randomization of the dates of the monthly prenatal courses, carried out by the coordinating center for each satellite center, using a computerized system; with blinded evaluator.

Study Record Dates

• First Submitted: September 9, 2025
• First Posted: September 19, 2025
• Study Start: January 1, 2023
• Primary Completion: December 12, 2023
• Study Completion: April 30, 2024
• Last Updated: September 19, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)