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Postnatal head growth in very premature infants with good outcome
S Fujimoto1, T Ishikawa, H Togari
1Department of Pediatrics, Nagoya City University Medical School, Japan.
Insights
This study tracked postnatal head growth in preterm infants born between 24-29 weeks gestational age. Head growth rates varied, slowing in later weeks for infants born at 27-29 weeks gestation.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Biology
Background:
- Premature infants, particularly those born extremely preterm, face risks for abnormal neurodevelopment.
- Accurate monitoring of head growth is crucial for identifying potential neurological issues in early life.
Purpose of the Study:
- To retrospectively analyze postnatal head growth patterns in infants born between 24 and 29 weeks of gestational age.
- To establish normative head growth curves for this vulnerable population.
- To identify potential differences in head growth trajectories based on gestational age at birth.
Main Methods:
- Retrospective analysis of head circumference measurements from 118 infants (24-29 weeks gestational age).
- Exclusion criteria included hydrocephalus, small for dates, cerebral palsy, epilepsy, and intellectual disability.
- Infants were grouped by gestational age (24-26, 27, 28, 29 weeks) and head circumference was measured bi-monthly.
- Head growth curves were generated, and average daily growth rates were calculated for specific postnatal periods.
Main Results:
- Following an initial transient decrease, head growth averaged 1.1-1.2 mm/day from postnatal days 21-70 across all groups.
- A notable difference emerged between postnatal days 61-100: infants born at 24-26 weeks averaged 1.2 mm/day, while those born at 27-29 weeks averaged 0.8 mm/day.
- These findings suggest a potential deceleration in head growth in later infancy for extremely preterm infants.
Conclusions:
- Postnatal head growth in preterm infants (24-29 weeks gestation) shows a consistent rate between 21-70 days.
- A significant slowing of head growth is observed between 61-100 days for infants born at later preterm gestations (27-29 weeks) compared to those born earlier (24-26 weeks).
- These distinct growth patterns highlight the importance of gestational age in predicting head growth trajectories in extremely preterm infants and may inform neurodevelopmental monitoring.
Abstract:
Postnatal head growth was examined retrospectively in 118 infants (male 60, female 58) born with a gestational age of from 24 to 29 weeks. Infants fulfilled the following criteria: (1) Those with hydrocephalus and small for dates (less than -1.5 standard deviation) were excluded. (2) Infants had normal intelligence and no cerebral palsy or epilepsy at 3 years of age or above. They were divided into four groups according to gestational ages: 24-26 wks (n = 21), 27 wks (n = 25), 28 wks (n = 41) and 29 wks (n = 31). The head circumference was measured at least twice monthly. The head growth curves in each group were obtained. After a transient decrease, head growth averaged 1.1-1.2 mm/day from day 21-30 to day 61-70 in all groups. From day 61-70 to 91-100 head growth averaged 1.2 mm/day at 24-26 wks and 0.8 mm/day at 27-29 wks, respectively.