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Neurocognitive and Psychiatric Outcomes in Pediatric Craniosynostosis: Insights for Plastic Surgery from a Retrospective Risk Analysis
Viraj Govani, BA
Mary Wilding, BS
Janina Kueper, MD
Aileen Cui, BS
Tobi Somorin, BS
Siri Ravuri, BS
Ashley Rogers, MD
Jesse Goldstein, MD
University of Pittsburgh School of Medicine
2025-01-09
Presenter: Viraj Govani
Affidavit:
This project is representative of original work from the entire team.
Director Name: Jesse Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction:
Despite surgical advances, evidence shows that patients with craniosynostosis continue to have significant neurodevelopmental differences when compared to their peers. This study examines these differences and their risk factors to guide tailored interventions and improve care.
Methods:
We retrospectively reviewed patients with craniosynostosis at UPMC Children's Hospital (2003–2023), examining demographics, clinical presentation, neurocognitive diagnoses, surgeries, and patient outcomes. Descriptive statistics, chi-square tests, t-tests, and logistic regressions were performed using STATA, with significance set at p<0.05.
Results:
An analysis of 719 pediatric patients with craniosynostosis (64.3% male, 83.0% Caucasian, mean diagnosis age 36.77±43.61 months) included 132 patients eventually diagnosed with neurocognitive and psychiatric disorders. Our patients had a mean Pediatrics Symptom Checklist score of 17.68±9.24, General Anxiety Disorder-7 score of 6.78±8.11, and Patient Health Questionnaire-9 score of 5.32±6.10.
Patients with squamosal and lambdoid craniosynostosis were significantly more likely to develop developmental delay (p=0.013), and patients with squamosal craniosynostosis were significantly more likely to develop autism spectrum disorder (ASD) (p=0.042). Each additional month of age at the time of diagnosis significantly raises the odds of developing ASD by approximately 1.08% (p=0.002), ADHD by approximately 1.42% (p<0.001), learning disorders by approximately 1.97% (p<0.001), and developmental delay by approximately 1.26% (p<0.001).
Conclusion:
This study underscores the critical importance of early diagnosis in craniosynostosis, as delayed detection was associated with increased rates of ASD, ADHD, developmental delay, and learning disorders. These associations highlight the intricate and interconnected relationship between craniosynostosis and the subsequent development of comorbid psychiatric and neurocognitive conditions in pediatric patients.
