Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2021.01417    [Accepted]
Published online December 9, 2021.
Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the national health screening program for infants and children database
Og Hyang Kim1, Seung Won Lee2, Eun Kyo Ha3, Ju Hee Kim4, Yun Hye Jo5, Seongyeong Rhie1, Man Yong Han1  , Kyu Young Chae1 
1Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
2Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
3Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
4Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
5Department of Global Economic, Gachon University, Seongnam, Gyeonggi-do, Korea
Correspondence: 
Man Yong Han, Email: drmesh@gmail.com
Kyu Young Chae, Email: drmesh@gmail.com
Received: 14 September 2021   • Revised: 3 November 2021   • Accepted: 5 November 2021
Abstract
Background
Congenital muscular torticollis (CMT) is a common musculoskeletal disorder occurring at birth or in infancy.Purpose: This study aimed to investigate the risk of comorbidities in congenital muscular torticollis (CMT) and explore the differences in neurodevelopmental outcomes between children who received physical therapy and those who did not.
Methods
Children with CMT born in 2008 and 2009 in Korea were included. CMT was defined as a primary diagnosis of congenital deformity of sternocleidomastoid muscle according to the International Classification of Diseases 10th revision. Here we investigated the associated neurological/musculoskeletal comorbidities of children with CMT versus those of the general population. We divided those with torticollis into treatment and non-treatment groups and assessed their developmental outcomes within both groups of children using the Korean-Ages and Stages Questionnaire (K-ASQ).
Results
Of the 917,707 children, 0.2% (n=1,719) were diagnosed with CMT. In children with torticollis, the prevalence of congenital hip deformities significantly increased to 4.5% (n=78). The prevalence of congenital head/spine deformities and other congenital malformations of the skull and facial bones increased to 2.6% (n=44), while the prevalence of congenital foot deformities was 2.4% (n=42). The risk ratio (RR) for delayed development based on the K-ASQ was higher for the total assessment (adjusted RR = 0.97; 95% confidence interval, 0.93–0.99) in the CMT patients without physical therapy than in those with therapy. There was no significant intergroup difference in the assessment of each developmental area.
Conclusion
The prevalence of comorbid musculoskeletal deformities was higher in children with CMT than in the control group. The risk of developmental delay was higher in children who did not receive physical therapy than in those who did.
Key Words: Congenital torticollis, Child, Comorbidity, Developmental disabilities


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