Social, Demographic and Health Risk Factors for Head Growth in Infants in Rural Guatemala: A Prospective Cohort Study

Area of Science:

• Pediatric growth and development
• Maternal and child health
• Epidemiology in low-resource settings

Background:

• Occipitofrontal circumference (OFC) is a key indicator of infant brain growth and development.
• Understanding risk factors for OFC variations is crucial, especially in vulnerable populations.
• Rural, low-resource settings present unique challenges to infant health and growth monitoring.

Purpose of the Study:

• To investigate social, demographic, and health risk factors associated with OFC growth in Guatemalan infants.
• To identify predictors of smaller OFC at birth and one year of age.
• To inform targeted interventions for improving infant head growth in similar settings.

Main Methods:

• Prospective cohort study of 430 infants in rural Guatemala (2017-2019).
• OFC measurements at enrollment (0.1-2.9 months) and one year later (11.5-16.1 months).
• Two-stage regression analysis (univariate and multivariable) to identify independent risk factors.

Main Results:

• Shorter maternal height and in utero exposure to Zika virus (ZIKV) were linked to smaller OFC at enrollment and one year.
• In utero cigarette smoking exposure was associated with smaller OFC at enrollment.
• Infant complications, microcephaly, and stunting at enrollment predicted smaller OFC at one year.

Conclusions:

• Key predictors of small OFC were identified within the first three months of life.
• Maternal height, and prenatal ZIKV and smoking exposures are significant early-life risk factors.
• Post-enrollment exposures did not predict OFC at one year, highlighting the importance of early-life interventions.