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Longitudinal head growth in developmentally normal preterm infants
R D Sheth1, M D Mullett, J B Bodensteiner
1Department of Pediatrics, West Virginia University Health Sciences Center, Morgantown, USA.
Insights
Infants born weighing over 1000g showed normal head growth. However, those born weighing 1000g or less had smaller head circumference measurements up to 18 months.
Area of Science:
- Pediatric Growth and Development
- Neonatal Research
- Public Health
Background:
- Low birth weight (LBW) is a significant predictor of infant health outcomes.
- Understanding head circumference (HC) growth is crucial for assessing neurodevelopment in LBW infants.
- Existing reference data may not fully capture the growth trajectory of extremely LBW infants.
Purpose of the Study:
- To evaluate head circumference growth from birth to 18 months in normal infants with low birth weight (LBW).
- To compare HC growth in LBW infants with established reference data.
- To identify potential growth discrepancies in infants with very low birth weight (VLBW).
Main Methods:
- Study included healthy, appropriate-for-gestational-age singleton infants with birth weight ≤ 2500g.
- Serial head circumference measurements were collected from birth to 18 months, corrected for gestational age.
- Infant HC data were compared against reference data for term infants.
Main Results:
- Infants with birth weight > 1000g exhibited HC measurements similar to reference data.
- Infants with birth weight ≤ 1000g showed significantly smaller HC measurements compared to reference data (P < .001).
- At 18 months, the mean HC difference for infants ≤ 1000g birth weight was 1.6 cm (P < .01).
Conclusions:
- Standard HC grids are suitable for monitoring growth in infants with birth weight > 1000g.
- Normal infants with very low birth weight (≤ 1000g) do not achieve catch-up head growth compared to larger premature or term infants.
- These findings highlight the need for specific growth monitoring considerations for VLBW infants.
Objective:
To determine growth in head circumference from birth to 18 months of age in normal infants with low birth weight.
Methods:
Healthy, appropriate-for-gestational-age, singleton, white infants weighing less than or equal to 2500 g at birth and with normal development at 18 months of age were included in this study. Serial measurements of head circumference (corrected for gestational age) from 450 eligible infants were compared with reference data for head circumference.
Results:
Longitudinal measurements of head circumference for infants weighing more than 1000 g at birth were similar to reference data for term infants. Head measurements for infants weighing less than or equal to 1000 g at birth were notably smaller than the measurements in the reference data. A cubic spline curve drawn through the head circumference measurements between birth and age 18 months (corrected for gestational age) for infants weighing less than or equal to 1000 g at birth was significantly (P < .001) below the curve for infants weighing more than 1000 g at birth. At age 18 months, the mean difference in head circumference between the group weighing less than or equal to 1000 g at birth and the weights in the reference data was 1.6 cm (P < .01). (Data were analyzed with Wilcoxon's signed rank test.)
Conclusions:
These data show that head circumference grids are appropriate for observing head growth in infants with a birth weight more than 1000 g. However, head circumference growth for normal infants with birth weight less than or equal to 1000 g does not "catch up" with that of larger premature infants or term infants.