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Measuring head circumference: Update on infant microcephaly
Insights
Regularly measuring infant head circumference (HC) is crucial for early detection of microcephaly. Prompt identification by family physicians can lead to timely referrals and intervention services for affected infants.
Area of Science:
- Pediatrics
- Neurology
- Developmental Biology
Background:
- Head circumference (HC) measurement is a key indicator of infant brain growth.
- Microcephaly, defined as HC more than 2 standard deviations below the mean, is associated with significant developmental challenges.
Purpose of the Study:
- To provide an evidence-based update on the importance of measuring infant head circumference.
- To highlight the significance of early detection and management of microcephaly.
Main Methods:
- Systematic literature search of PubMed and EMBASE databases.
- Inclusion of recent studies (published 2000 or later) with a focus on evidence level II.
Main Results:
- Serial HC measurement should be integrated into routine well-child care.
- Microcephaly is linked to intellectual delay, epilepsy, cerebral palsy, and various other congenital anomalies.
- Early intervention programs and therapies can benefit infants with microcephaly and developmental delays.
Conclusions:
- Early identification of HC abnormalities by family physicians is critical.
- Referral to pediatric specialists and family-centered early intervention services are essential for infants with microcephaly.
Objective:
To provide an evidence-based update emphasizing the importance of measuring head circumference (HC) in infants, with a focus on microcephaly.
Quality Of Evidence:
PubMed and EMBASE (OvidSP) were searched. Search terms used were head circumference and infants and measurement; microcephaly and infants and measurement; idiopathic microcephaly and infants; and congenital microcephaly and infants. Most of the references for this review were published in 2000 or later. Most evidence is level II.
Main Message:
Serial measurement of HC should be incorporated into routine well-child care. Measure the distance around the back of the child's head with a nonelastic tape measure held above the eyebrows and ears, and plot the measurement on an age- and sex-appropriate growth chart. Microcephaly is HC more than 2 SD below the mean. The most common disability associated with microcephaly is intellectual delay; other common concomitant conditions include epilepsy, cerebral palsy, language delay, strabismus, ophthalmologic disorders, and cardiac, renal, urinary tract, and skeletal anomalies. An interdisciplinary approach to microcephaly is warranted. Although there are no specific interventions to enhance brain growth, dietary or surgical interventions might be helpful in some cases. Infants with microcephaly who show developmental delays might benefit from early intervention programs or developmental physical and occupational therapy.
Conclusion:
Early identification of HC concerns by family physicians can be a critical first step in identifying disorders such as microcephaly, leading to referral to pediatric specialists and, as needed, provision of family-centred early intervention services.
