探讨中国西北延安地区婴儿颅型异常的流行病学特征及相关因素分析。

回顾性分析2024年9月至2025年8月在北京大学第三医院延安分院就诊并完成颅型测量的1 406例婴儿临床资料。按就诊时的年龄，分为3组：0~4月龄组、5~8月龄组和9~12月龄组，并依据测量结果将颅型异常分为轻、中、重度。采用χ²检验结合Bonferroni法对3组患儿颅型异常的发生率及其原因进行分析，并采用Cochran-Armitage趋势检验分析颅型异常发生率随月龄增长的线性趋势。采用Kruskal-Wallis H检验比较不同月龄段婴儿颅型异常等级的整体分布差异。

1 406例婴儿中，0~4月龄组、5~8月龄组和9~12月龄组分别为554，470，382例。颅型异常的患儿812例，3组分别为345，265，202例。其中，单纯斜头异常、单纯短头异常、斜头合并短头异常和舟状头异常发生率分别为14.9%(210/1 406)、18.6%(262/1 406)、21.9%(309/1 406)和2.2%(31/1 406)。3组婴儿短头异常总体检出率比较，差异有统计学意义(χ²＝10.070，P< 0.01)，且发生率随月龄增长呈下降趋势(趋势检验：χ²＝10.066，P< 0.01)。3组婴儿斜头异常总体检出率及舟状头检出率比较，均差异无统计学意义(χ²＝1.707，0.084，均P> 0.05)。在颅型异常患儿中，0~4月龄组患儿早产、围产期不良因素及先天性肌性斜颈发生率[11.9%(41/345)，2.09%(72/345)，5.5(19/345)]高于5~8月龄组[5.3%(14/265)，6.4%(17/265)，0.4%(1/265)]和9~12月龄组[6.4%(13/202)，9.4%(19/202)，0.5%(1/202)]，仰卧位固定睡姿的发生率低于大月龄组[80.0%(276/345)，89.8%(238/265)，90.1%(182/202)]，均差异有统计学意义(χ²＝9.828，30.692，20.323，16.004；均P< 0.01)。

婴儿颅型异常以斜头合并短头最为常见；短头异常随月龄增长呈下降趋势。早产、围产期不良因素及先天性肌性斜颈是早期(< 4个月)婴儿发生颅型异常的相关因素，早期筛查和针对性干预至关重要。

To investigate the epidemiological characteristics and identify associated factors of cranial deformities among infants in the Yan′an region of northwestern China.

This retrospective study analyzed the clinical data of 1 406 infants undergoing cranial measurements at the Yan′an Branch of Peking University Third Hospital between September 2024 and August 2025. Participants were stratified by age into 3 groups (0-4, 5-8, and 9-12 months), and based on the measurement results, cranial deformities were classified into mild, moderate, and severe categories. Chi-square tests with Bonferroni correction evaluated differences in incidence rates and etiologies across groups. The Cochran-Armitage test analyzed linear trends with age, and the Kruskal-Wallis H test compared the overall distribution of deformity severity.

Among the 1 406 infants, 554 were aged 0-4 months, 470 were aged 5-8 months, and 382 were aged 9-12 months, of whom 812 presented with cranial deformities (345, 265, and 202 cases across the respective groups). The overall incidences of isolated plagiocephaly, isolated brachycephaly, combined plagiocephaly and brachycephaly, and scaphocephaly were 14.9% (210/1 406), 18.6% (262/1 406), 21.9% (309/1 406), and 2.2% (31/1406), respectively. The detection rate of isolated brachycephaly differed significantly among groups (χ²=10.070, P< 0.01) and showed a decreasing trend with increasing age (trend test: χ²=10.066, P<0.01). No significant differences were observed for plagiocephaly and scaphocephaly (χ²=1.707, 0.084, all P> 0.05). Among infants with cranial deformities, the 0-4 month group had significantly higher rates of prematurity [11.9%(41/345)], adverse perinatal factors [20.9%(72/345)], and congenital muscular torticollis [5.5%(19/345)] compared to the 5-8 month [5.3%(14/265), 6.4%(17/265), 0.4%(1/265)] and 9-12 month [6.4%(13/202), 9.4%(19/202), 0.5%(1/202)] groups. Conversely, the rate of fixed supine sleeping positioning was the lowest in the 0-4 month group [80.0%(276/345), 89.8%(238/265), 90.1%(182/202)] (χ²=9.828, 30.692, 20.323, 16.004, all P<0.01).

Combined plagiocephaly and brachycephaly is the most common infant cranial deformity, while isolated brachycephaly incidence shows a decreasing trend with increasing age. Prematurity, adverse perinatal factors, and congenital muscular torticollis are associated factors for early-onset (<4 months) deformities, highlighting the critical need for early screening and targeted interventions.