[Ability of neonatal head circumference to predict long-term neurodevelopmental outcome]
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Updated: Aug 21, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A García-Alix1, M Sáenz-de Pipaón, M Martínez
1Servicio de Neonatología, Departamento de Pediatría, Hospital Universitario La Paz, Madrid, Spain. alfredoalix@vodafone.es
Insights
Head circumference (HC) at birth and neonatal head growth are simple tools to predict neurodevelopmental outcomes. Abnormal head size or growth can indicate brain damage, with catch-up growth being a positive prognostic sign.
Area of Science:
- Neonatal care
- Pediatric neurology
- Developmental pediatrics
Context:
- Head circumference (HC) is a key indicator of brain development in infants.
- Abnormal head size or growth patterns can signal underlying neurological issues.
- HC assessment is crucial for high-risk neonates, including very low birth weight infants.
Purpose:
- To review the predictive value of head circumference and head growth for neurodevelopmental outcomes.
- To highlight recent advancements in understanding the relationship between head growth and neurological function.
- To emphasize the utility of HC measurements in identifying neonates at risk for developmental disorders.
Summary:
- Head circumference (HC) closely correlates with intracranial and cerebral volume during infancy.
- Deviations in HC at birth or during the neonatal period may indicate brain damage or neurological dysfunction.
- The significance of HC alterations is often linked to the underlying cause and associated brain pathologies.
Impact:
- Head circumference measurement and growth evaluation are simple, cost-effective tools for assessing central nervous system development.
- These methods aid in the early identification of neonates requiring closer neurodevelopmental monitoring.
- Catch-up head growth in the neonatal period is a favorable indicator for long-term neurodevelopmental prognosis.
Aim:
We review the ability of head circumference (HC) at birth and head growth during the neonatal period to predict neurodevelopmental outcome, putting emphasis on new knowledge in this area.
Development:
During infancy HC correlates closely with intracranial volume and constitutes an accurate predictor of cerebral volume. Both an abnormal head size at birth and an abnormal head growth during the neonatal period, can express brain damage or the presence of entities that involve varied degrees of neurological dysfunction in childhood. In general, the influence of head size or growth abnormalities on neurodevelopment is more related to the underlying etiology and/or the presence of structural diseases of the brain than with the HC alteration itself. HC evaluation is of particular interest in sick neonates, specially very low birth weight infants, regardless of whether they are normal or small for gestational age, and both during admission an during the first months of life. In these patients, HC catch-up within the first months of life represents a favorable neurodevelopmental prognostic factor.
Conclusion:
HC measuring and head growth evaluation constitute the most simple, inexpensive and quick available tools to assess the development of the central nervous system and identify neonates at risk of neurodevelopmental disorders.
