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Developmental implications of head growth following intracranial hemorrhage

M Bendersky1, A Koons, M Lewis

  • 1Institute for the Study of Child Development, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.

Clinical Pediatrics
|September 8, 1998
PubMed

Insights

Head size in preterm infants impacts development. Normal head growth by one year is linked to better outcomes, especially for those without intracranial hemorrhages (ICH). Persistent periventricular echodensities (PVE) indicate deficits regardless of head size.

Area of Science:

  • Neonatal neuroscience
  • Developmental pediatrics
  • Pediatric neurology

Background:

  • Preterm infants are at risk for neurodevelopmental deficits.
  • Head circumference is a key indicator of brain growth and development.

Purpose of the Study:

  • To investigate the relationship between head size at birth, discharge, and 1 year, and developmental outcomes in preterm infants.
  • To assess the influence of intracranial hemorrhages (ICH) and periventricular echodensities (PVE) on this relationship.

Main Methods:

  • Longitudinal study of 125 preterm infants.
  • Assessment of head circumference at birth, discharge, and 1 year.
  • Evaluation of neurodevelopmental outcomes (mental and motor) at 1 year.
  • Analysis of the presence and persistence of ICH and PVE.

Main Results:

  • Most preterm infants with small head size at discharge achieved normal head size by 1 year.
  • For infants without ICH, appropriate head size at birth and discharge predicted better 1-year developmental outcomes.
  • Small head size (<2 SD below mean) before discharge was associated with poorer outcomes.
  • For infants with ICH, only normal head size at 1 year predicted better outcomes.
  • Persistent PVE correlated with mental and motor deficits at 1 year, irrespective of head growth.

Conclusions:

  • Head growth trajectory, particularly achieving normal head size by 1 year, is crucial for neurodevelopmental outcomes in preterm infants.
  • The presence of ICH and PVE significantly modifies the impact of head size on development.
  • Persistent PVE is a strong predictor of long-term neurodevelopmental deficits in this population.

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