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Velocity of head growth during the perinatal period
Insights
Infant head growth velocity differs by gestational age. Preterm infants show delayed peak head growth but achieve larger head circumference than term infants in the first five months.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Biology
Background:
- Head circumference growth is a key indicator of infant development.
- Understanding growth patterns in appropriate-weight-for-dates (AFD) and small-for-dates (SFD) infants is crucial.
- Longitudinal data on head growth velocity across different gestational ages is limited.
Purpose of the Study:
- To longitudinally study head circumference growth velocity in healthy infants.
- To compare growth patterns between appropriate-weight-for-dates (AFD) and small-for-dates (SFD) infants.
- To analyze the impact of gestational age on head growth velocity during the first five postnatal months.
Main Methods:
- Longitudinal study of 222 AFD and 94 SFD healthy infants up to 5 months of age.
- Analysis of head circumference growth velocity across different gestational age groups.
- Estimation of fetal head growth velocity using cross-sectional data.
Main Results:
- Term AFD and SFD infants exhibited a steady decrease in head growth velocity post-birth.
- Preterm infants (<36 weeks gestation) showed an initial increase in head growth velocity, peaking between 30-40 days.
- High caloric feeding in very preterm infants (30-33 weeks) normalized their velocity curve compared to later preterm infants.
- Fetal head growth velocity slows from 31 weeks gestation; term infants show a postnatal surge.
Conclusions:
- Head growth velocity patterns vary significantly based on gestational age and postnatal feeding.
- Preterm infants, despite delayed peak growth velocity, achieve larger head circumferences by 5 months postnatally compared to term infants.
- Gestational age and postnatal factors significantly influence head circumference development in early infancy.
Abstract:
Growth velocity of head circumference was studied longitudinally in different gestational age groups of 222 appropriate-weight-for-dates (AFD) and 94 small-for-dates (SFD) healthy infants during the first 5 months of life. Term AFD and SFD infants showed a steady slowing of growth rate of head circumference from birth. In contrast, preterm AFD infants of less than 36 weeks' gestation showed an increasing velocity of growth followed by slowing, with maximum velocity occurring between 30 and 40 days after birth. The shorter the postconceptional age at birth the later maximum velocity occurred. However, those preterm AFD infants of between 30 and 33 weeks' gestation who were given a high caloric feed showed a similar velocity curve to that of infants of 34-37 weeks of gestation. Cross-sectional data were used to estimate growth velocity of head circumference in the fetus. Two conclusions emerged. First, there is a slowing of head growth velocity from 31 weeks' gestation in utero, and second, term infants show a marked increase in volocity after birth. Though the occurrence of maximum velocity of head growth is delayed in the preterm infant, the net effect is such that at a given postconceptional age his head circumference is greater than that of the term infant, at least within the first 5 postnatal months.