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.     

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.     

Head circumference charts updated.

Head circumference measurements from birth to 7 years, obtained from longitudinal data on children born between 1970 and 1977, are set against those from studies made in the United Kingdom earlier this century. A positive secular trend is shown. The children''s heads were significantly larger than those born in the same locality 25 years earlier. Growth charts should be updated, as necessary, with each succeeding generation.     

Head circumference, biparietal diameter and brain growth in fetal and postnatal life

The curves for biparietal diameter, head circumference and brain weight with increasing age have different shapes, and these differences have been explained. Interconversion procedures are suggested. One important consequence of changing growth velocities relates to assessing prognosis for catch-up following adversity. On the assumption that catch-up of brain growth must occur within the period of the brain weight growth spurt, the interpretation of head circumference charts is discussed.     

The effect of perinatal risk factors on growth in very preterm infants at 2 years of age: the Leiden Follow-Up Project on Prematurity

OBJECTIVE: To describe growth in infants <32 weeks GA. To assess the relationship between growth and perinatal factors (like intrauterine growth retardation and the postnatal use of dexamethasone) and neurodevelopmental outcome. DESIGN: Regional, prospective study in two health regions in the Netherlands. Part of the Leiden Follow-Up Project on Prematurity (LFUPP). PATIENTS: 196 live born infants with GA <32 weeks. METHODS: At two years corrected age length, weight and head circumference of 160 of 196 surviving infants (82%) were evaluated. Standard Deviation Scores were calculated and means were compared to Dutch growth references. Mean SDS for length was corrected for the mean SDS for target height. Birth weight (BW)-SDS for gestational age (GA) was calculated according to Swedish references. RESULTS: Length, weight and weight-for-length were equally impaired in both sexes at two years in premature infants compared to Dutch growth charts. Catch-up in length and weight occurred mostly in the first year of life. Intrauterine growth retardation was associated with impairment of all growth parameters. The use of postnatal dexamethasone was associated with shorter length, lower weight, lower weight for length and smaller head circumference; this effect remained after correction for GA, BW and BW-SDS. Growth retardation (length and weight) was associated with an abnormal neurologic examination; smaller head circumference also with mental and psychomotor delay. CONCLUSION: Growth at two years corrected age in children born <32 weeks is impaired. Postnatal dexamethasone is associated with impairment of all growth parameters including head circumference, which may be a significant contributing factor for abnormal neurodevelopmental outcome.     

Longitudinal study of the pubertal growth spurt in children born small for gestational age without postnatal catch-up growth

Most children born small for gestational age (SGA) experience extensive catch-up growth during the first months of life (87%) and by the age of 2 years only 13% are below -2 SDS for height. The long-term outcome, including pubertal growth spurt, of the subset of children born SGA without postnatal catch-up (SGAWPC) has been evaluated in very few surveys, and in none of them was the landmarks of puberty well described. Thus, a longitudinal study was conducted in these children throughout puberty since this is the only reliable way to accurately evaluate the pubertal growth spurt. In an observational, retrospective and multicenter collaborative study, from an initial group of 553 SGA children, a subset of 15 boys (BW = 2,070 +/- 379.6 g) and 16 girls (BW = 2,244 +/- 331.1 g) SGAWPC whose data were recorded regularly during puberty were selected. Growth standards for growth and maturity during puberty were Tanner and Whitehouse and Spanish Hernandez and Sobradillo charts. In pubertal growth spurt, 'take-off' occurred later than in the reference populations with a height SDS deficiency of -2.3 and -2.2 for boys and -2.0 and -1.9 for girls, compared with Spanish and Tanner references, respectively. Peak height velocity was normal in chronology and intensity, but the total pubertal gain was smaller. However, considering their growth from the same chronological age at which the reference populations took off until adulthood, the total gain was not significantly different in the three cohorts (32.5 +/- 5.4 cm vs 30.9 +/- 4.4 in boys, and 23.3 +/- 4.1 vs 25.7 +/- 5.4 cm in girls - Spanish reference - and 27.2 +/- 6.3 vs 27.6 +/- 3.5 cm in boys - Tanner charts), except in the case of girls (21.1 +/- 3.9 vs 25.3 +/- 4.1 cm, p <0.005 - Tanner charts). Adult height was significantly reduced (161.9 +/- 3.9 cm in males and 147.0 +/- 2.6 cm in females). Therefore, although the pubertal growth was smaller in these children, puberty probably did not modify their short final height.     

Association of Rapid Head Growth in Children Following Tracheostomy Tube Placement

IntroductionOur clinical observation indicates that some children who have a tracheostomy may experience increasing head circumference as they grow and develop. Accurate assessment and interpretation of growth parameters is an essential component of following child development. Appreciation for variations in growth is especially important in special populations, such as children with a tracheostomy. The aim of this study is to define head growth in children with a tracheostomy.MethodThis retrospective cohort study includes children who underwent tracheostomy tube placement prior to 2 years of age in a respiratory rehabilitation unit within a children's hospital. Serial head circumference measurements were plotted against age on growth charts adjusted for gestational age. The percentage of patients with accelerated head growth, defined as increased head circumference across two major percentiles within 6 months following tracheostomy, was determined.ResultsFifty-seven percent (20 out of 35 children) demonstrated increased head circumference across two major percentiles within 6 months following tracheostomy.DiscussionAccelerated head growth is associated with the presence of a tracheostomy tube in children in this study. Further investigation is warranted to establish the relationship of head circumference to other growth parameters. In addition, the etiology of this phenomenon requires additional study. Understanding head growth in children with a tracheostomy will promote adequate growth assessment and may lead to improved patient care.     

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.     

Growth Characteristics of Preschool Aboriginal Children

Cox, J. W. (1979). Aust. Paediatr. J. , 15, 10–15. Growth characteristics of preschool Aboriginal children . Many Australian Aborigines appear small for age when they start attending school. The growth records of over 500 Aboriginal children born since 1970 and living on five Aboriginal communities in Cape York, Queensland are analysed. For the first two to three months of life, the Aborigines appear to have similar measurements for weight and head circumference as British children. Growth retardation occurring at 3 to 12 months of age is partially compensated by a "catch-up" spurt during the following 1–2 years. This does not fully compensate for the check during the critical period of head growth and the resultant mean head circumference remains below the British average.
It seems that the small head circumference and light weight, characteristic of the Aboriginal school child is primarily attributable to growth failure and is not a racial characteristic.     

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.     

Secular trend of growth in Malaysian children

Over the past hundred years in industrialised countries and recently in some developing countries, children have been getting larger and growing to maturity more rapidly. This paper compares the growth of Malaysian children with similar socioeconomic backgrounds but born about twelve years apart. Data were obtained from records of 227 children born between 1968 and 1973 and 238 children born between 1980 and 1985. The children were followed-up regularly at the University Hospital Child Health Clinic in Kuala Lumpur for a variable period from birth to five years of age. Measurements for their weight, length and head circumference were taken at each visit. There is a directional indication that boys and girls of the 1980-1985 cohort are taller, heavier and have bigger head circumferences from birth to five years of age and the difference widens as the child grows older. This study clearly shows that a positive secular trend has taken place in the last decade, reflecting an improvement of living conditions with time. The factors involved in the positive secular trend are manifold and the most important is probably nutrition.     

Growth of head circumference of Malaysian infants and pre-school children

126 Malaysian children, 65 boys and 61 girls from higher income families were followed-up regularly from birth to six years of age in the University Hospital, Kuala Lumpur. The study confirms the observations of previous studies that growth velocity of head circumference is most rapid during the first few months of infancy and then decreases so that by the fifth year of life the increment is minimal. It also confirms the fact that boys have bigger head circumferences than girls. The paper also presents the head circumference distance and velocity percentile charts which can be used to monitor the head circumference of Malaysian children.     

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.     

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.     

Head circumference standards for Irish children

A cross-sectional study measuring head circumference was performed on 3,344 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.     

Head circumference standards for school children of Shiraz, Iran

The measurements of head circumference (HC) of 2228 healthy school children (1160 boys and 1068 girls) aged 6.5-11.5 years are presented for the first time. The data were sampled in a multistage scheme and collected through a large-scale cross-sectional growth study carried out in Shiraz, the capital of Fars province of Iran. The results indicated that the HC measurements centiles of the girls lied below that of the boys in all age groups. Comparison of our data of the children with their peers in Turkey, Ireland, Japan and USA showed that on average, girl, HC measurements in Shiraz are larger that of their Turkish counterparts up to the age of 10 years and lie on that later on, but smaller than that of their peers from other mentioned studies. However, boys' HC measurements of Shiraz are lower than that of their peers at all ages. The article, therefore, concludes that the standards for HC will differ from country to country and supports local standards in this regard.     

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.     

Are there critical periods for brain growth in children born preterm?

BACKGROUND: Children born very preterm who attend mainstream schools have a high prevalence of minor motor, behavioural, and learning disorders. These appear to be associated with reduced postnatal growth, particularly of the head. It is unclear when this poor growth occurs and whether growth restriction during different periods has different effects on later function. OBJECTIVE: To identify periods during early development, in children born preterm, when impaired head growth may influence minor motor and cognitive function. POPULATION: A geographically defined cohort of 194 infants born in Merseyside during 1980-81 and weighing less than 1500 g. METHODS: Measurements of head circumference (occipitofrontal circumference (OFC)) were available at birth, hospital discharge, 4 years, and 15 years of age. Assessments of intelligence (intelligence quotient (IQ)) and minor motor impairment (test of motor impairment (TOMI)) were made at 8 years of age. Clinical, social, and demographic variables were obtained from the clinical record and maternal interviews. RESULTS: IQ correlated significantly with OFC at 4 and 15 years of age after correction for growth restriction at birth (intrauterine growth restriction (IUGR)) and social class. TOMI scores correlated significantly with OFC at all four times, but especially with OFC at discharge and with change in OFC between birth and discharge. They were not affected by correction for social class or IUGR. CONCLUSION: Although both IQ and minor motor impairments correlate strongly with each other at school age in very low birthweight children, the factors determining them and their timing of operation are different. Interventions designed to improve IQ in this population would need to reduce IUGR and improve later childhood growth. Those aimed to improve motor ability need to be targeted more at brain protection during the neonatal period.     

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.