Positional Plagiocephaly and Excessive Folic Acid Intake during Pregnancy

Abstract

Objective

To assess the relationship between high intake of folic acid and positional plagiocephaly.

Design

Retrospective case-control study with questionnaires administered in the clinic to biological mothers of children with positional plagiocephaly (PP group) and mothers of children without it (CO group).

Setting

Tertiary, institutional clinic. University Hospital of Maastricht, The Netherlands.

Patients, Participants

Exclusion criteria: mothers of children with syndromic disease or bone deformation and of children with clearly continuous forces on the skull (torticollis). A total of 94 mothers were included in the PP group (response rate: 85%), and 74 were included in the CO group (response rate: 75%). Final sample sizes were 75 in the PP group and 54 in the CO group.

Main Outcome Measures

The recommended daily dosage of folic acid in The Netherlands is 400 μg. The primary outcome was folic acid dosage in relation to the recommended dosage. A secondary outcome was duration of folic acid intake in relation to the recommended period of use during pregnancy.

Results

In the PP group, 20% used double the recommended dosage of folic acid, compared with 6% in the CO group (p < .05). In the CO group, 59% used folic acid longer than recommended compared with 56% in the PP group (not significant). There were no differences in baseline characteristics except for gestational period: 39.5 weeks in the PP group and 37.9 in the CO group (p < .05).

Conclusion

Excessive daily intake of folic acid during pregnancy is seen among mothers of positional plagiocephaly patients.