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Postnatal head shrinkage in small infants

J Williams, N J Hirsch, A J Corbet

    Pediatrics
    |April 1, 1977
    PubMed
    Summary
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    Premature infants experience head shrinkage in the first week of life, correlating with weight and sodium loss. This transient phenomenon is linked to fluid shifts within the intracranial cavity.

    Area of Science:

    • Neonatal physiology
    • Pediatric research
    • Infant development

    Background:

    • Premature infants (<2,000 gm) undergo significant physiological changes post-birth.
    • Accurate measurement of head parameters is crucial for assessing infant health.
    • Understanding early postnatal fluid shifts is key to neonatal care.

    Purpose of the Study:

    • To investigate head size changes in premature infants during the first week of life.
    • To identify factors influencing postnatal head shrinkage.
    • To explore the relationship between head shrinkage and physiological parameters like weight and sodium balance.

    Main Methods:

    • Daily measurements of head circumference, diameters, and weight in 50 low-birth-weight infants.
    • In a subset of 21 infants, daily measurements included sodium balance.

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  • Head volumes were calculated from measured head dimensions.

    • Main Results:

    • Head size parameters and estimated head volumes showed maximal shrinkage around day 3 of life.
    • Head shrinkage significantly correlated with weight loss and cumulative sodium losses.
    • Decreasing gestational age was also significantly associated with the degree of head shrinkage.

    Conclusions:

    • Postnatal head shrinkage in premature infants is a transient phenomenon.
    • This shrinkage is likely caused by a shift of sodium and water out of the intracranial cavity.
    • The findings highlight the importance of monitoring fluid and electrolyte balance in very low-birth-weight infants.