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Postnatal-onset microcephaly: pathogenesis, patterns of growth, and prediction of outcome

N Paul Rosman1, Daniel C Tarquinio, Marianna Datseris

  • 1Department of Pediatrics, Division of Pediatric Neurology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA. npaul.rosman@bmc.org

Pediatrics
|March 23, 2011
PubMed

Insights

Children with postnatal-onset microcephaly (POM) often have poor development. However, better body growth, including weight, height, and head circumference, predicts more favorable developmental outcomes in these children.

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Clinical Genetics

Background:

  • Postnatal-onset microcephaly (POM) is associated with significant developmental challenges in affected children.
  • Understanding factors that influence developmental trajectories in POM is crucial for early intervention and prognosis.

Purpose of the Study:

  • To investigate the relationship between somatic growth parameters (weight, height, head circumference) and developmental quotient (DQ) in children with POM.
  • To identify predictors of neurodevelopmental outcomes in a cohort of children diagnosed with POM.

Main Methods:

  • A longitudinal study followed 57 children with POM (encephaloclastic, dysgenetic, Rett syndrome, idiopathic) for an average of 4.2 years.
  • Developmental quotient (DQ) was assessed regularly; SD scores for weight, height, and head circumference were analyzed using mixed-effects models.
  • Pearson's correlation examined the independent influence of growth parameters on final DQ.

Main Results:

  • 77% of children with POM exhibited a low DQ; however, 23% achieved normal DQ, predominantly in the idiopathic group.
  • Mean head circumference fell below -2 SDS before age 1 year in all etiological subgroups.
  • Weight, height, and head circumference were significant independent predictors of DQ (P < .0001), with height showing the strongest correlation (r = 0.41).

Conclusions:

  • While most children with POM experience poor development, sustained postnatal growth is linked to more favorable outcomes.
  • Approximately one-quarter of children with POM, particularly those with idiopathic causes, can achieve normal developmental quotients.
  • Somatic growth parameters serve as important indicators for predicting developmental trajectories in children with POM.
Abstract

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