Prevalence and Factors Associated with Neonatal Occipital Alopecia: A Retrospective Study

BACKGROUND: For many years, the etiology of neonatal occipital alopecia (NOA) has been thought to be friction. It is recently clear that NOA is related to the physiological hair shedding. OBJECTIVE: We sought to evaluate the prevalence and factors associated with NOA. METHODS: Medical records of 240 postpartum patients who had been delivered between January 2006 and June 2007 at our institution were reviewed. Phone interviews with 193 respondents were conducted to investigate the actual conditions of NOA. RESULTS: NOA was present in 39 babies (20.2%). Univariate analysis showed that NOA was not associated with the baby's sleeping position, but was significantly associated with maternal parturition age, the delivery method, and the gestational age (p<0.05). In multiple logistic regression analysis, the risk of NOA was higher in the group younger than 35 years at parturition (OR, 3.86; 95% CI, 1.08~13.82), in the group not undergoing a Caesarean-section delivery (2.47; 1.09~5.60), and in the group delivered after 37 weeks of gestational age (3.36; 1.22~9.26). CONCLUSION: The pregnancy-related factors, such as non-elderly gravida, non-Caesarean-section delivery, and enough gestational age, were associated with NOA. These findings support the recent theory that NOA is not an acquired alopecia, but a physiological condition, resulting from synchronized shedding of telogen hairs initiated in utero.