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Head Circumference Versus Length and Weight Deficits up to 2 Years of Age in Bangladesh

Leanna Cho1, Alison S B Dasiewicz1, Kelly M Watson1

  • 1Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.

Maternal & Child Nutrition
|December 26, 2024
PubMed

Insights

Infant head circumference (HC) deficits were observed in Bangladeshi newborns up to two years, indicating no head sparing. Routine HC measurement in low- and middle-income countries is recommended for better infant nutrition assessment.

Area of Science:

  • Global Health
  • Pediatrics
  • Human Nutrition

Background:

  • Infant undernutrition is prevalent in low- and middle-income countries (LMICs).
  • While length and weight deficits are monitored, head circumference (HC) deficits are less studied.
  • Head size is a crucial indicator of infant brain development and overall health.

Purpose of the Study:

  • To compare head circumference (HC) deficits with length and weight deficits in term newborns in Dhaka, Bangladesh.
  • To assess the severity and persistence of HC deficits from birth to 2 years of age.
  • To determine if postnatal head sparing occurs in this cohort.

Main Methods:

  • Longitudinal cohort study of term newborns in Dhaka, Bangladesh (n=843-920).
  • Measurement of head circumference (HC), length, and weight at birth and every 3 months until 2 years.
  • Calculation of HC, length, and weight-for-age z-scores (HCZ, LAZ, WAZ) against WHO Growth Standards.
  • Statistical analysis using paired t-tests and quantile regression to compare z-scores; HCZ also derived using height-age.

Main Results:

  • Mean HCZ was higher than LAZ and WAZ at birth but significantly lower from 6 months onwards.
  • HC deficits relative to length (LAZ) were similar from 15 to 24 months.
  • HC deficits persisted even when standardized by height-age, indicating reduced head growth relative to body size.
  • Patterns were consistent across the 25th, 50th, and 75th percentiles.

Conclusions:

  • Term-born infants in Dhaka exhibit smaller head circumferences than international standards up to 2 years.
  • There was no evidence of postnatal head sparing in this population.
  • Routine measurement of HC should be considered in LMIC population health surveys for comprehensive infant assessment.

Keywords:
anthropometrycephalometrychild developmentcrown‐rump lengthdeveloping countriesgrowth and developmentmalnutrition

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