Head Circumference Standards for Irish Children

Abstract. A cross-sectional study measuring head circumference was performed on 3344 Irish Children aged from 5 to 19 years. Comparison with other countries showed a slightly larger head circumference than the 1965 British standards produced by Tanner, but significantly smaller than the Ounsted data from Oxford. There Was no significant difference between the urban and rural children, but the children of non-manual workers had a significantly larger head than those of manual workers.     

Growth in Head Circumference from Birth to Fifteen Years of Age in Japan

Growth charts for head circumference in Japanese children from birth to fifteen years of age are presented. The charts were compiled from the pooled data obtained in a prospective longitudinal study on development and growth in Nagoya city. An adolescent growth spurt in head circumference was found and this spurt occurred earlier in girls than in boys. Heads were smaller up to the age of 10 years and larger beyond that age than those in Nellhaus' composite charts. The heads of children of both sexes in our study are definitely smaller than those of children born in the United Kingdom in the same period, but they are considerably larger than those of children born in Japan more than 50 years ago. Therefore, the standards for head circumference will differ from country to country and from generation to generation.     

Growth in head circumference from birth to fifteen years of age in Japan

Growth charts for head circumference in Japanese children from birth to fifteen years of age are presented. The charts were compiled from the pooled data obtained in a prospective longitudinal study on development and growth in Nagoya city. An adolescent growth spurt in head circumference was found and this spurt occurred earlier in girls than in boys. Heads were smaller up to the age of 10 years and larger beyond that age than those in Nellhaus' composite charts. The heads of children of both sexes in our study are definitely smaller than those of children born in the United Kingdom in the same period, but they are considerably larger than those of children born in Japan more than 50 years ago. Therefore, the standards for head circumference will differ from country to country and from generation to generation.     

Head circumference, height, bone age and weight in 103 children with congenital hypothyroidism before and during thyroid hormone replacement

Head circumference, height, bone age and weight were studied in 103 children with congenital hypothyroidism before and up to 8 years of thyroid replacement therapy. The patients were divided into 4 groups according to the age at start of treatment: group I (diagnosed by neonatal screening): less than 2 weeks (n = 55); group II: 1-3 months (n = 7); group III: 4-12 months (n = 15); group IV: greater than 1 year of age (n = 26). Before treatment, group I showed a head circumference significantly larger than normal and a delay in bone maturation in the presence of normal length and weight. In the other groups length as well as bone age were significantly lower than normal, head circumference, in contrast, was normal (groups II and III) or even increased (group IV). During therapy, head circumference and bone age of group I became normal as were length and weight from the beginning. In the other groups, therapy led to a further increase of head size resulting in a mean head circumference significantly larger than normal during 8 years of observation in group IV. There was a catch-up of height, bone age and weight in groups II, III and IV; mean height of late treated children (group IV), however, remained significantly lower than normal even after 8 years of therapy. - Our study shows that congenital hypothyroidism is associated with increased head circumference, either absolutely or in relation to stature. Thyroid hormone therapy resulted in a normalization of head growth when treatment was initiated early, and in a further increase when treatment was started late. There was a catch-up of height, bone age and weight; complete normalization, however, occurred only in those children treated before one year of age.     

Could head circumference be used to screen for autism in young males with developmental delay?

Aim: Research has suggested an abnormal acceleration in head circumference growth in children with autism within the first 12 months of life. This study aimed to examine head circumference at birth and head circumference growth rates in young children with autism and developmental delay, and young children with developmental delay without autism. Methods: This study assessed head circumference at birth and rate of change in head circumference in young children with autism (n= 86) and children with developmental delay without autism (n= 40). Results: For both groups of children, head circumference at birth and head circumference growth were compared with Centers for Disease Control normative data. No differences were found between the group of children with autism and developmental delay compared with the group with developmental delay only. However, when the sample was compared with a range of selected Centers for Disease Control normative medians, the children with autism were found to have significantly smaller head circumferences at birth and significantly larger head circumference at 18.5 months of age. Conclusions: These results are discussed in relation to the potential of accelerated head circumference growth as an early marker for autism. This study failed to find a difference in the head circumferences of children with autism and developmental delay and children with developmental delay only, thus suggesting that head circumference measurement has limited value as an early marker for autism.     

Children of alcoholic mothers. Growth and motor performance compared to matched controls

Twenty-one children born 1970-76, selected from 103 children of 30 alcoholic women, were paired to controls matched for sex, age, birth weight and gestational age. The sample (10 girls, 11 boys) was representative of the whole group with regard to weight, length and head circumference at birth. At follow-up (mean age 70 months) the study group was significantly leaner, shorter and had smaller mean head circumference than the control group. The controls had significant catch-up growth from birth to follow-up of weight, height and head circumference to the mean for Swedish children. The study group had no catch-up growth. Compared to controls the study group had significantly lower fine and gross motor age test scores and inferior coordination. One child had cerebral palsy (spastic hemiplegia) and in 6 other children slight tremor and ataxia were observed. Malformations and/or other signs of the fetal alcohol syndrome (FAS) were found in 10 cases. Study group children with FAS had significantly slower growth of head circumference than others without FAS. Children placed in foster home care (n = 11) were found to have significantly (p less than 0.05) lower birth weight, birth length and head circumference than children raised at home (n = 10). There were no significant differences at follow up between study group children raised in foster homes or in homes of their biological mother.     

Children of Alcoholic Mothers: Growth and Motor Performance Compared to Matched Controls

ABSTRACT. Twenty-one children born 1970-76, selected from 103 children of 30 alcoholic women, were paired to controls matched for sex, age, birth weight and gestational age. The sample (10 girls, 11 boys) was representative of the whole group with regard to weight, length and head circumference at birth. At follow-up (mean age 70 months) the study group was significantly leaner, shorter and had smaller mean head circumference than the control group. The controls had significant catch-up growth from birth to follow-up of weight, height and head circumference to the mean for Swedish children. The study group had no catch-up growth. Compared to controls the study group had significantly lower fine and gross motor age test scores and inferior coordination. One child had cerebral palsy (spastic hemiplegia) and in 6 other children slight tremor and ataxia were observed. Malformations and/or other signs of the fetal alcohol syndrome (FAS) were found in 10 cases. Study group children with FAS had significantly slower growth of head circumference than others without FAS. Children placed in foster home care ( n =11) were found to have significantly ( p <0.05) lower birth weight, birth length and head circumference than children raised at home ( n =10). There were no significant differences at follow up between study group children raised in foster homes or in homes of their biological mother.     

Diagnostik der Neurofibromatose Typ 1 im Kindesalter

Background

NF1 is a frequent phakomatosis with an autosomal dominant mode of inheritance. Diagnosis based on the NIH criteria often leads to delayed disease recognition in childhood.

Patients and methods

A total of 102 NF1 patients from all over Germany and with a mean age of 10.8 years were investigated. In addition to NIH criteria, first dentition, body weight, body height and head circumference (1–9) were documented. A control population of 51 unaffected siblings of the patients and a group of healthy, unrelated children were examined for comparison.

Results

The proportion of children who had early eruption of milk teeth was higher in the NF1 patient population (31%) than among their healthy brothers and sisters (8.9%). There was no difference in body height and weight between the NF1 patients and healthy children of the same age in the first 5 years of life. From the end of the 1st year onward NF1 patients had a significantly larger head circumference than the other children studied.

Conclusion

The greater proportion of children with earlier eruption of milk teeth than average among NF1 children and their larger head circumference from the end of their 1st year onward could reinforce suspicions of NF1. Therefore, diagnostic procedures in the first 5 years of life should include vigilance for further signs such as macrocephaly and earlier eruption of milk teeth, especially in children with a new mutation of NF1.     

Growth and skeletal maturation in children with phenylketonuria

Schaefer F, Burgard P, Batzler U, Rupp A, Schmidt H, Gilli G, Bickel H, Bremer HJ. Growth and skeletal maturation in phenylketonuria. Acta Paediatr 1994;83:534–41. Stockholm. ISSN 0803–5253 Growth and skeletal maturation was evaluated in 82 children participating in the German Colkdborative Study of Children Treated for Phenylketonuria (PKU). Height, weight, head circumference and bone age were recorded at regular intervals for the first 6 years of life. The mean SD score (SDS) for height was not significantly different from zero at study entry, but decreased mainly during the second year of life to a nadir of -0.78 in boys and -0.54 in girls at 2.5 years. During the subsequent years, a significant trend towards a regain of height SDS was noted in both sexes. Weight-for-height SDS was close to zero in both sexes, with a significant continuous increasing trend throughout the observation period. Head circumference SDS decreased in boys during the first year of life from -0.28 to -0.68, whereas girls showed only a minor change. During the further follow-up period, head circumference SDS remained at approximately -0.3 in boys and 0.0 in girls. While the mean verbal and performance IQ of the total study population at 5 and 6 years of age did not differ from a group of 212 healthy non-PKU children, patients with a head circumference SDS less than the population median at 2 years of age exhibited poorer cognitative abilities at school age than those patients with a relative head size greater than the population median. The children with a head circumference less than the median at 2 years had smaller head sizes already at birth; in addition, the change in relative head size during the first 2 years was correlated significantly with cognitive abilities at school age in boys. Mean bone age was identical to chronological age at each time point of observation. The rate of maturation was one year of bone age per year of chronological age. No correlation between phenylalanine intake or phenylalanine concentrations and the rates of body or head growth or skeletal maturation could be established. We conclude that despite adequate weight gain, moderate growth retardation occurred during the first 2 years of life in this group of children treated for PKU. Growth was more compromised in boys than in girls and tended to be compensated during later follow-up. Early infantile head circumference and growth appear to be predictors of cognitive development.     

�����ȳ��ͼ����ȳ���С��̥������������Ƚ�

??Objective??To find the difference in growth and development of children between full-term symmetric growth restriction??FSGR?? and full-term asymmetric growth restriction??FAGR?? through a general investigation of children born small for gestational age in Shanghai. Methods??This general investigation covered all children under 6 years old in Shanghai. Data on growth were retrospectively obtained from medical records. The P10 of birth head circumference/birthweight of the same gestational age and gender was used to distinguish FSGR and FAGR. Results??The sample contained 10 188 full-term SGA children among whom 8049 were FAGR and 2139 were FSGR. Up to 3 years old??both FSGR and FAGR failed to catch up in weight??height??head circumference and chest circumference. Growth restriction in FAGR was more serious. Significant difference could be seen in weight??t??-3.412??P??0.001?? and chest circumference??t??-2.526??P??0.012?? between FSGR and FAGR at 3 years old. Regarding growth speed??the growth rate of weight ??t??6.272??P??0.001????height ??t??9.143??P??0.001????head circumference ??t??6.063??P??0.001?? and chest circumference ??t??6.617??P??0.001?? were higher in FAGR 6 months after birth??while there was no difference after that. The BMI of FAGR was significantly lower than FSGR before 2 years old. The proportion of children in danger of being overweight was significantly higher in FSGR ??P??0.001??. Conclusion??Both FSGR and FAGR experience catch-up growth after birth??but not enough to catch up with normal children at 3 years old??especially in head circumference. In spite of severer growth restriction??the cath-up growth model of FAGR is superior to FSGR. The proportion of children in danger of being overweight is significantly higher in FSGR.     

Growth and proportionality in early childhood. II. Some population differences

The postnatal growth patterns of children in four different populations are compared with a sample born and brought up in Oxford. Three indices of proportionality were investigated. Among the three caucasian groups Swedish children had the smallest heads and tallest stature, resulting in particularly low head-chest and head-stature ratios. Denver children had unusually small chest from 2 years onwards; their head-chest ratios were significantly higher than those in Oxford, but head-stature and chest-stature ratios were lower. Japanese children were smaller than Oxford children in all dimensions; but apart from some minor fluctuations they were similar in shape by all three indices used. Guatemalan children of both sexes had extremely high chest-stature ratios from 3 years onwards. Head-stature ratios were also raised, but to a lesser extent. Compared with children in more highly-favoured communities their stature and head circumference were reduced more than weight and chest circumference.     

A comparison of height, weight and head circumference of primary school children living in deprived and non-deprived circumstances.

Heights, weights and head circumferences were obtained from two groups of primary school children: 1016 children from throughout Oxfordshire, a rural county with few areas of deprivation, and 219 children from an economically deprived part of the city of Newcastle on Tyne. Compared to Tanner and Whitehouse standards, Oxfordshire children were significantly taller, but not heavier, while the Newcastle children were significantly shorter and markedly lighter. Mean head circumference values were lower in the Newcastle than the Oxfordshire children. Existing national growth standards are outdated when applied to children in acceptably advantaged circumstances while impoverished children still fall below these standard in a pattern suggestive of under nutrition.     

Growth and proportionality in early childhood. III. Differences between babies of low birthweight in well-nourished and malnourished populations

The growth patterns from birth to 7 yr of four groups of children are compared. They comprise: small-for-gestational age children in a highly favoured community born to (A) short mothers, (B) mothers of average height for their population; Guatemalan children living in a community where mild to moderate protein-calorie malnutrition was endemic. Data on a sample of children whose birthweights covered the normal range for gestational age were used as reference standards. At all ages and for almost all measures they were significantly larger than children in the other three groups. No differences were found between the boys in groups A and B; but girls in group A were lighter and shorter from 18 mth onwards. The Guatemalans were shorter and had smaller heads than group A from 12 mth onwards; and the boys were also lighter. No differences were found between the Guatemalans and group A for chest circumference in either sex from 2 yr onwards. Deficits in size at 4 yr of the Guatemalans compared with the Reference Sample ranged from 8.8% for stature, 6.8% head circumference, 5.9% weight, down to 3.9% for chest circumference. The differences between the four groups may broadly be taken to represent those due to low birthweight for gestational age, lower genetic potential, postnatal malnutrition, and their cumulative effects. Our findings offer a new perspective on their varying contributions to growth in size and shape during early childhood.     

Standards for height, weight and head circumference from one month to six years based on Stockholm children born in 1980

Growth data on height, weight and head circumference were collected from Stockholm children from one month to six years of age, born in 1980, and representing all socio-economic groups. The sample consisted of 2471 children (1264 boys and 1207 girls), most of whom were measured on 10–15 occasions. From these measurements centile standards were constructed using a statistical technique which separates between-individual and within-individual variation, since only the former is appropriate to distance standards. Compared to former Swedish standards the present heights and weights were similar up to 2.0 years of age but thereafter considerably greater. Head circumference was larger throughout, perhaps due to a difference in measurement technique.     

The association of growth impairment with neurodevelopmental outcome at eight years of age in very preterm children

BACKGROUND: The relative contributions of poor growth before and after birth in very preterm infants to subsequent outcomes at school-age are not certain. AIMS: To determine the associations between weight and head circumference, at birth and postnatally, with cognitive, academic and motor outcomes at age 8 years for very preterm children free of neurosensory impairment. STUDY DESIGN: This was a regional cohort study from the state of Victoria, Australia. SUBJECTS: 179 very preterm infants (<28 weeks' gestational age) born in 1991 and 1992 who were free of neurosensory impairment. OUTCOME MEASURES: At 8 years of age children had cognitive, academic and motor assessments. Weight and head circumference data were collected at birth, at the time of discharge (weight only), at 2 years of age and at 8 years of age, and growth restriction was calculated using Z-scores (standard deviation scores) relative to the expected mean for age. RESULTS: Very preterm children were significantly lighter and had smaller head circumferences than the reference group at all ages. Weight at any age was mostly unrelated to any outcomes. While head circumference at birth was not related to school-aged outcomes, smaller head circumferences at ages 2 and 8 years were associated with poorer performance in most outcome measures. Catch-up growth in weight in early childhood was not associated with 8-year outcomes. CONCLUSIONS: Intrauterine growth restriction was not substantially associated with neurodevelopmental status at age 8. Weight after birth had little influence, but head circumference became more important in early childhood.     

Maternal fish oil supplementation in lactation and growth during the first 2.5 years of life

Fish oil addition to infant formulas has raised concern on whether increased intake of n-3 long-chain polyunsaturated fatty acid (n-3LCPUFA) affects infant growth. The objective of this study was to determine whether maternal fish oil supplementation during 0-4 mo of lactation influences growth in infancy and early childhood. In a randomized, blinded intervention trial, lactating Danish mothers with a fish intake below the population median were randomized to 4.5 g/d fish oil or olive oil. A reference group of 53 mothers with a fish intake in the highest quartile of the population and their infants were included in the study. Head circumference, weight, length, skinfold thickness, and waist circumference of children were measured at 2, 4, and 9 mo and at 2.5 y. One hundred children completed the intervention trial, and 72 were followed up at 2.5 y together with 29 from the reference group. Growth in weight, length, and head circumference did not differ between the randomized groups up to 9 mo, but at 2.5 y, body composition differed significantly. Children in the fish oil group had larger waist circumference body mass index (BMI; 0.6 kg/m(2); p = 0.022), and head circumference compared with those in the olive oil group. Adjusted for sex, ponderal index at birth and current energy intake, BMI at 2.5 y was associated with docosahexaenoic acid in maternal erythrocytes after the intervention. In conclusion, the n-3LCPUFA intake of lactating mothers may be important for growth of young children. The long-term effect on weight and BMI remains to be investigated.     

A comparison of the mid-arm circumference/head circumference ratio and ponderal index for the evaluation of newborn infants after abnormal intrauterine growth

We studied the accuracy of the ponderal index and the mid-arm circumference/head circumference ratio for detecting newborn infants who were likely to be symptomatic because of aberrant intrauterine growth. Sixty infants were evaluated because of suspected intrauterine growth retardation; both the mean ponderal index and mid-arm circumference/head circumference ratio were significantly lower in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants (p less than 0.05). However, the mid-arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (80% vs. 47%; p = 0.007). An additional 60 infants were evaluated because of suspected abnormal intrauterine growth acceleration. The mean mid-arm circumference/head circumference ratio, but not the ponderal index, was significantly higher in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants (p less than 0.005). Again, the mid-arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (79% vs. 33%; p less than 0.001). The mid-arm circumference/head circumference ratio is more accurate than the ponderal index for the evaluation of potentially symptomatic newborn infants who suffered abnormal fetal growth. The ponderal index is not useful for the detection of symptomatic large-for-dates infants.     

A Comparison of the Mid-Arm Circumference/Head Circumference Ratio and Ponderal Index for the Evaluation of Newborn Infants after Abnormal Intrauterine Growth

ABSTRACT. We studied the accuracy of the ponderal index and the mid-arm circumference/head circumference ratio for detecting newborn infants who were likely to be symptomatic because of aberrant intrauterine growth. Sixty infants were evaluated because of suspected intrauterine growth retardation; both the mean ponderal index and mid-arm circumference/head circumference ratio were significantly lower in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants ( p <0.05). However, the mid-arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (80% vs. 47%; p =0.007). An additional 60 infants were evaluated because of suspected abnormal intrauterine growth acceleration. The mean mid-arm circumference/head circumference ratio, but not the ponderal index, was significantly higher in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants ( p <0.005). Again, the mid-arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (79% vs. 33%; p <0.001). The mid-arm circumference/head circumference ratio is more accurate than the ponderal index for the evaluation of potentially symptomatic newborn infants who suffered abnormal fetal growth. The ponderal index is not useful for the detection of symptomatic large-for-dates infants.     

Birthweight and subsequent growth of children exposed to rubella infection in utero

Birthweight, and head circumference and body weight at preschool age were studied in a group of 212 children exposed to maternal rubella infection. Birthweights were compared to standards for birthweights of British children according to gestational age and birth rank. Children with detectable rubella antibody at the time of the examination were regarded as seropositive and those with no detectable antibody as seronegative. It was shown that the mean birthweight of seronegative and seropositive children without rubella defects did not differ significantly from the 50th centile or from each other, but that those who were seropositive with defects had significantly lower birthweights. Head circumference and body weight were similarly compared to current British standards. Head circumference at follow-up was normal in seronegative and seropositive children without defects, but significantly low in seropositive children with defects, even if retinopathy was the sole defect. The findings for body weight at follow-up were similar, reflecting absence of catch-up growth in weight in the children with congenital rubella defects.This study has shown that intrauterine growth retardation does not present as the sole manifestation of maldevelopment in congenital rubella.     

Very low birth weight and growth into adolescence

OBJECTIVE: To compare the growth and pubertal development of very low-birth-weight (VLBW) children (birth weight <1500 g) and normal-birth-weight (NBW) children (birth weight >2499 g) to adolescence to determine if, and at what age, VLBW children "catch up." DESIGN: Inception cohort study to age 14 years. SETTING: Royal Women's Hospital, Melbourne, Australia. PATIENTS: Eighty-six consecutive survivors with a birth weight less than 1000 g, 120 consecutive survivors with a birth weight of 1000 to 1499 g, and 60 randomly selected NBW controls. Children with cerebral palsy at age 14 years were excluded. MAIN OUTCOME MEASURES: Weight, height, and head circumference measurements at birth and ages 2, 5, 8, and 14 years converted to z (SD) scores. RESULTS: At age 14 years, pubertal development was similar in NBW and VLBW children. At ages 2, 5, 8, and 14 years, VLBW children were significantly shorter and lighter and had smaller head circumferences than NBW children. The differences in height and weight between VLBW and NBW children were less apparent as SD scores improved in VLBW children over time. Within the VLBW group, compared with children with a birth weight of 1000 to 1499 g, those with a birth weight less than 1000 g had significantly lower weight z scores earlier in childhood but not at age 14 years, significantly lower height z scores only at age 2 years, and significantly lower head circumference z scores throughout childhood. CONCLUSION: This group of VLBW children experienced late catch-up growth to age 14 years but remain smaller than their NBW peers. Arch Pediatr Adolesc Med. 2000;154:778-784