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. 2009 Sep;155(3):344-9.e1-3.
doi: 10.1016/j.jpeds.2009.04.002. Epub 2009 Jun 24.

Developmental correlates of head circumference at birth and two years in a cohort of extremely low gestational age newborns

Karl C K Kuban  1 , Elizabeth N Allred, T Michael O'Shea, Nigel Paneth, Sjirk Westra, Cindy Miller, N Paul Rosman, Alan Leviton
Affiliations

Developmental correlates of head circumference at birth and two years in a cohort of extremely low gestational age newborns

Karl C K Kuban et al. J Pediatr. 2009 Sep.

Abstract

Objectives: To evaluate the developmental correlates of microcephaly evident at birth and at 2 years in a cohort born at extremely low gestational age.

Methods: We assessed development and motor function at 2 years of 958 children born before the 28th week of gestation, comparing those who had microcephaly at birth or 2 years with children with normal head circumference while considering the contribution of neonatal cranial ultrasound lesions.

Results: A total of 11% of infants in our sample had microcephaly at 2 years. Microcephaly at 2 years, but not at birth, predicts severe motor and cognitive impairments at 2 years. A total of 71% of children with congenital microcephaly had a normal head circumference at 2 years and had neurodevelopmental outcomes comparable with those with normal head circumference at birth and 2 years. Among children with microcephaly at 2 years, more than half had a Mental Developmental Index <70, and nearly a third had cerebral palsy. The risks were increased if the child also had cerebral white matter damage on a cranial ultrasound scan obtained 2 years previously.

Conclusion: Among extremely low gestational age newborns, microcephaly at 2 years, but not at birth, is associated with motor and cognitive impairment at age 2.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Correlates of head circumference. These box and whiskers plots of head circumference at birth (on the left) and head circumference at 24 months post-term equivalent (on the right) identify the 25th percentile by the bottom of the box, the median by the line close to the middle of the box, and the 75th percentile by the top of the box. The dispersion of the head circumferences are indicated by the length of the vertical lines that emanate from the box, as well as by the block dots, which identify outliers. At 2 years, each type of CP is associated with microcephaly, although only association with quadriparesis reached nominal significance. Children who had microcephaly at age 2 years were also at increased risk of more severe motor impairment (higher GMFCS score) and low Bayley Scale scores.
Figure 1
Figure 1
Correlates of head circumference. These box and whiskers plots of head circumference at birth (on the left) and head circumference at 24 months post-term equivalent (on the right) identify the 25th percentile by the bottom of the box, the median by the line close to the middle of the box, and the 75th percentile by the top of the box. The dispersion of the head circumferences are indicated by the length of the vertical lines that emanate from the box, as well as by the block dots, which identify outliers. At 2 years, each type of CP is associated with microcephaly, although only association with quadriparesis reached nominal significance. Children who had microcephaly at age 2 years were also at increased risk of more severe motor impairment (higher GMFCS score) and low Bayley Scale scores.
See this image and copyright information in PMC

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