Relationships between Head Circumference,Brain Volume and Cognition in Children with Prenatal Alcohol Exposure

Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5–19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol exposure, but raise concerns about the predictive value of this metric at an individual-subject level.     

Parasitism in Children Aged Three Years and Under: Relationship between Infection and Growth in Rural Coastal Kenya

Background

Parasitic infections, which are among the most common infections worldwide, disproportionately affect children; however, little is known about the impact of parasitic disease on growth in very early childhood. Our objective was to document the prevalence of parasitic infections and examine their association with growth during the first three years of life among children in coastal Kenya.

Methodology/Principal Findings

Children enrolled in a maternal-child cohort were tested for soil transmitted helminths (STHs: Ascaris, Trichuris, hookworm, Strongyloides), protozoa (malaria, Entamoeba histolytica and Giardia lamblia), filaria, and Schistosoma infection every six months from birth until age three years. Anthropometrics were measured at each visit. We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference). Of 545 children, STHs were the most common infection with 106 infections (19%) by age three years. Malaria followed in period prevalence with 68 infections (12%) by three years of age. Filaria and Schistosoma infection occurred in 26 (4.8%) and 16 (2.9%) children, respectively. Seven percent were infected with multiple parasites by three years of age. Each infection type (when all STHs were combined) was documented by six months of age. Decreases in growth of weight, length and head circumference during the first 36 months of life were associated with hookworm, Ascaris, E. histolytica, malaria and Schistosoma infection. In a subset analysis of 180 children who followed up at every visit through 24 months, infection with any parasite was associated with decelerations in weight, length and head circumference growth velocity. Multiple infections were associated with greater impairment of linear growth.

Conclusions/Significance

Our results demonstrate an under-recognized burden of parasitism in the first three years of childhood in rural Kenya. Parasitic infection and polyparasitism were common, and were associated with a range of significant growth impairment in terms of weight, length and/or head circumference.     

Influence of variation in birth weight within normal range and within sibships on IQ at age 7 years: cohort study

ObjectiveTo examine the relation between birth weight and measured intelligence at age 7 years in children within the normal range of birth weight and in siblings.DesignCohort study of siblings of the same sex.Setting12 cities in the United States.Subjects3484 children of 1683 mothers in a birth cohort study during the years 1959 through 1966. The sample was restricted to children born at ⩾37 weeks gestation and with birth weights of 1500-3999 g.ResultsMean IQ increased monotonically with birth weight in both sexes across the range of birth weight in a linear regression analysis of one randomly selected sibling per family (n= 1683) with adjustment for maternal age, race, education, socioeconomic status, and birth order. Within same sex sibling pairs, differences in birth weight were directly associated with differences in IQ in boys (812 pairs, predicted IQ difference per 100 g change in birth weight =0.50, 95% confidence interval 0.28 to 0.71) but not girls (871 pairs, 0.10, −0.09 to 0.30). The effect in boys remained after differences in birth order, maternal smoking, and head circumference were adjusted for and in an analysis restricted to children with birth weight ⩾ 2500 g.ConclusionThe increase in childhood IQ with birth weight continues well into the normal birth weight range. For boys this relation holds within same sex sibships and therefore cannot be explained by confounding from family social environment.

What is already known on this topic

IQ at school age is linked to birth weight among low birthweight babiesSome evidence suggests the association might also apply to children of normal birth weight

What this study adds

IQ at age 7 years is linearly related to birth weight among children of normal birth weightThe relation was not due to confounding by maternal or socioeconomic factorsIQ is also associated with differences in birth weight between boy sibling pairs but not girls     

Physical growth of infants 7 to 13 months of age: results from a national survey

This study considers measurements of weight, recumbent length, head circumference, triceps skinfold, and arm circumference of 1,100 infants aged 7 to 13 months from a cross-sectional sample representative of the U.S. infant population. Based on these data, smoothed percentiles of weight, recumbent length, head circumference, triceps skinfold, and arm circumference by sex and age (in months) and weight for recumbent length were calculated. Compared with the percentile values from the National Center for Health Statistics (NCHS; Hamill et al., 1977, DHEW Publ. No. PHS 78-1650), percentile values from the 1984 Ross Laboratories Infant Nutrition Survey (RNS) for weight, recumbent length, and weight for recumbent length tended to be smaller (p less than .05). We attribute these variations to differences in sampling design and conclude that they are not of sufficient magnitude to warrant new growth charts. Smoothed percentiles for triceps skinfold and arm circumference presented herein are new reference values that can be used for assessment of the nutritional and growth status of older infants.     

The need of specific standards for head dimensions of urban Sardinian boys

In the 1997-1998 and 1998-1999 school years we measured head dimensions of 1600 boys from 6 to 13 years attending elementary and middle schools in towns of the Cagliari area (Sardinia, Italy). For each age, we compared the mean values for circumference, length and width of the head with Canadian standards, widely used by Sardinian pediatricians. The t-test shows that the means of the three variables are significantly lower in the Cagliari boys than in their Canadian contemporaries, with the exception of head circumference in 6 and 7 year-olds, and of head width in 10 year-olds. Therefore, it is necessary to produce specific growth charts for circumference, length and width of the head of Sardinian children rather than evaluate their growth using standards of populations with different ethnic, geographical and socio-economic backgrounds.     

Developmental relations between the weight of internal organs and somatic features of fetuses and newborns

The paper contains results of investigations on statistical developmental interrelations between the weight of brain, heart, lungs, liver, spleen, kidneys, adrenal glands and thymus, and the total length, the crown-rump length and the body weight, and the circumference of head, shoulders, chest and abdomen of fetuses and newborns in the age from 17 to 43 weeks of life. The character and the force of the relations between the degree of the development of the weight of organs and the body dimensions was investigated by statistical methods on three levels. On the basis of the value of linear correlation coefficients, statistical relations were determined between the weight of the particular organs and the particular sometic features. The dependence between the particular organs and the complex of somatic features was determined on the basis on the multiple regression analysis. On the other hand the relation between two complexes of features, i.e. all organs and all somatic features was investigated with the help of canonical correlation coefficients. The analysis of results indicated that between the weight of internal organs and the somatic features in the fetal period there exists a statistical developmental relation. The developmental relations are most strongly marked between the 6th and the 10th months of intrauterine life, while in the 5th month of life and in postmature fetuses and newborns they are weaker.     

Craniofacial variation and growth in the Prader-Labhart-Willi syndrome

A study of anthropometric variation and craniofacial growth in individuals with the Prader-Labhart-Willi syndrome (PLWS) illustrates the utility of anthropometry in clinical evaluation and research. Anthropometric measurements, including head length and breadth, minimum frontal diameter, and head circumference, were obtained on 38 PLWS individuals (21 with chromosome 15 deletions) with an age range from 2 weeks to 39 years. No anthropometric differences were found between the two chromosome subgroups. A relative deceleration in the growth of certain craniofacial dimensions (head circumference and length) is suggested by the negative correlations between age and Z-scores for the measurements. Raw values for minimum frontal diameter and head breadth were near or below the 5th percentile curve, while almost all values for head length and circumference fell within normal limits. The data support suggestions that dolichocephaly be considered an early diagnostic feature of PLWS. Furthermore, the status of narrow bifrontal diameter as a major feature of PLWS is confirmed.     

Sexual dimorphism in schoolchildren of the Villa IAPI neighborhood (Quilmes,Buenos Aires,Argentina)

Villa IAPI is a poor neighborhood of about 5,000 inhabitants in the overpopulated conurbano bonaerense at the outskirts of the city of Buenos Aires. Most of the adult male residents are construction workers; the rest are temporary workers, underemployed, or unemployed. The inhabitants of Villa IAPI suffer the effects of many adverse socio-economic conditions, including poor nutrition, deficient sanitation, and inadequate medical care. Seven anthropometric variables were measured on 765 children from 6 to 14 years old to test for the presence of an altered pattern of sexual dimorphism. It was found that there were practically no sex differences in standing height and upper-arm muscle circumference. In some age groups, there was a weak but significant sexual dimorphism in body weight and sitting height. The greatest and most persistent dimorphism was found in head circumference, and in triceps and subscapular skinfolds. In all except two age groups, head circumference in males was significantly greater than in females. The other dimorphic variables (body weight, sitting height, and triceps and subscapular skinfolds) showed the opposite relationship. Essentially, females showed increments in subcutaneous fat, while reduced growth in muscle and bone was evident in males. The hypothesis of “better female canalization” can explain the altered dimorphic pattern found in the malnourished Villa IAPI population. © 1993 Wiley-Liss, Inc.     

Inbreeding effects on fetal growth in Beirut, Lebanon

Effects of consanguineous marriages on offspring's gestational age and anthropometrics at birth were investigated in Beirut through a hospital-based survey of 1,252 newborns. Twenty-five percent of all newborns were inbred, and the mean inbreeding coefficient was 1.25%. Neither prematurity rate nor weight, length, head circumference, and chest circumference (considered individually, or as a whole) showed a significant pattern by type of parental consanguinity. Failure to demonstrate significant inbreeding effects is reported in several other studies and generally interpreted as the long-term result of continued inbreeding practices.     

Growth and nutritional status of the Bharia--a primitive tribe of Madhya Pradesh

This study is an attempt to understand the physical growth and nutritional status of Bharia, a primitive tribe of Central India. A cross sectional study was conducted on 551 children (283 boys and 268 girls) aged 4 to 18 years. Body weight, height, sitting height, head circumference, upper arm circumference, chest circumference, biceps, triceps, sub scapular and calf skin fold thickness were measured. Body Mass Index was calculated as weight/height2 to calculate chronic energy deficiency. All anthropometric measurements except skin fold measurement exhibit uniform increase with age in both the sexes. Age-specific Body Mass Index (BMI) indicated substantial changes and falls during pre-school age and rise in adolescence. The BMI according to the Indian standard was normal, but when the data was compared with the International standard malnutrition in both sexes was noticed in childhood. Boys remained undernourished after adolescence, while girls reached the normal growth patterns.     

Effect of Ascaris infection on the nutritional status and I.Q. of children

It was estimated that about 1.3 billion persons all over the world were infected with Ascaris Lumbricoides (A.L.), Especially children in tropical and subtropical countries. AIM To investigate the effects of A.L. infection on the nutritional status and the intellectual level in a sample of Egyptian primary school children from rural Giza province. SUBJECTS AND METHODS A sample of 637 children (329 boys and 308 girls) aged 6–12 years, have been subjected to some anthropometric measurements including body weight, body height, arm circumference, head circumference and triceps skinfold thickness. In addition, the I.Q. was determined using “Draw-a-man” test. Blood hemoglobin concentration was also determined using a spectrophotometric method. All the children were then subjected to stools and urine examinations, and peri-anal swab. Only 242 children were included for further study, of whom 45 boys and 38 girls were found infected with A.L. solely, and 81 boys and 78 girls of about the same age free of parasitic infections were taken as control. RESULTS Children infected with A.L. has significantly lower body weight, height, and arm circumference but insignificantly lower skinfold thickness and head circumference as comparedto the control group. Infected children had significantly lower hemoglobin concentration and I.Q. than the controls. CONCLUSIONS Selected anthropometric measurements, biochemical and intellectual tests from a useful complementary battery for reliable and informative investigation of the effects of parasitic infection on child nutrition and health. A.L. was found to have a significant effect on the physical and intellectual status of the rural Egyptian children of age 6–12 years.     

Fetal and infant head circumference sexual dimorphism in primates

Studies have shown that after controlling for the effects of body size on brain size, the brains of adult humans, rhesus monkeys, and chimpanzees differ in relative size, where males have a greater volume of cerebral tissue than females. We assess whether head circumference sexual dimorphism is present during early development by evaluating sex differences in relative head circumference in living fetuses and infants within the first year of life. Head circumference is used as a proxy for brain size in the fetus and infant. Femur length is used as a proxy for body length in the fetus. Ultrasonography was used to obtain fetal measures, and anthropometry was used to obtain postnatal measures in humans, rhesus monkeys, baboons, and common marmosets. We show that statistically significant but low levels of head circumference sexual dimorphism are present in humans, rhesus monkeys, and baboons in early life. On average, males have head circumferences about 2% larger than females of comparable femur/body length in humans, rhesus monkeys, and baboons. No evidence for head circumference sexual dimorphism in the common marmoset was found. Dimorphism was present across all body size ranges. We suggest that head circumference sexual dimorphism emerges largely postnatally and increases throughout maturation, particularly in humans who reach adult dimorphism values greater than the monkeys. We suggest that brain dimorphism is not likely to impose an additional energetic burden to the gestating or lactating mother. Finally, some of the problems with ascribing functional significance to brain size sexual dimorphism are discussed, and the energetic implications for brain size sexual dimorphism in infancy are assessed.     

A Statistical Skull Geometry Model for Children 0-3 Years Old

Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.     

Birth weight,length, head circumference and bilirubin level in Indian newborns in the Sioux Lookout Zone,northwestern Ontario.

The norms for birth weight, length, head circumference and bilirubin level for native newborns have not been available. To develop appropriate norms, data were obtained from the charts on all live births in the Sioux Lookout Zone, northwestern Ontario, in 1968-69 and 1974-77. These data were correlated to maternal age and parity as well as sex of the infant. Despite impoverished living conditions, the birth weights of the study population were significantly higher than the Canadian norms; length and head circumference, however, were not significantly different. Over one third of the infants had serum bilirubin levels greater than 12 mg/dL (205 mumol/L). Increased maternal age was associated with increased birth weight and length and a lower bilirubin level.     

Growth and Fluctuating Asymmetry of Stepchildren

Parental caretaking is critical for child health and psychological development. Evolutionary logic and empirical studies suggest that stepchildren sometimes may receive less care and experience more traumas than genetic offspring. In this article, we investigate the effects of stepfamily environment on children's physical growth as part of a 12-year (1988–1999) project investigating child health in a rural village on the east coast of Dominica. Participants were 238 children aged 0–20 (X = 10.53) residing in the village of Bwa Mawego. Information on family environments was collected continuously since 1988. Here we analyze data from a longitudinal series of anthropometric measures collected in 1997, 1998, and 1999. To assess general growth, we measured height, weight, head circumference, triceps skinfold, subscapular skinfold, and peri-umbilical skinfold. We also collected medical records of weight from birth through 3 years of age. To assess fluctuating asymmetry (FA), we measured bilateral (right and left side) arm circumference, calf circumference, wrist breadth, ankle breadth, ear breadth, ear height, and length of digits 2–5. Coresidence with stepfather was associated with suboptimal growth. Female stepchildren aged 0–10 and male stepchildren aged 10–20 had lower body weight for age than other children, including their coresident half-siblings. Stepchildren and nonstepchildren had similar weights at birth, and similar muscle and fat cross-sections. Contrary to expectations, FA of stepchildren was lower than in other children. Recognition of the high risk of poor growth for stepchildren is important because of subsequent associations with morbidity, psychological problems, and educational performance. Why stepchildren had significantly lower FA than others warrants further investigation.     

Testicular development, body weight changes, puberty and semen traits of growing guzerat and Nellore bulls

One hundred fifty-nine purebred Guzerat (8 to 110 months of age) and sixty Nellore bulls (8-30 months of age) were used in two trials to examine testicular development and consistency, body weight changes, puberty and semen traits. Scrotal circumference measurements and semen collections by electroejaculation were made every 28 d. At both trial locations, bulls were maintained under grazing conditions and fed commercial protein supplements (2 kg/head/day) during the dry season. Age and body weight affected (P<0.01) scrotal circumference in both breeds. Scrotal circumference increased (P<0.01) linearly with age and body weight. However, scrotal circumference tended to reach mature size more rapidly than did body weight in both Guzerat and Nellore bulls. Correlation coefficients between scrotal circumference and semen traits were positive (P<0.01) ranging from 0.49 to 0.73 in the two breeds, but were not significant for testicular consistency in either breed. Scrotal circumference and age at puberty of Guzerat and Nellore bulls averaged 25.6 +/- 2.2 cm at 18.0 +/- 2.0 mo and 23.6 +/- 0.2 cm at 18.5 +/- 2.7 mo, respectively. Nellore bulls were 42 kg lighter than Guzerat at puberty. Testicular consistency was not affected by either age of body weight (P>0.10) in these young bulls. The percentages of abnormal spermatozoa were higher (P<0.01) at 13 to 15 mo of age in Guzerat (11.1%) and Nellore (14.4%) bulls than at 22 to 24 mo (6.7 and 8.0%, respectively). These data indicate that scrotal circumference measurements can be a useful tool for selecting and improving semen traits of young Guzerat and Nellore bulls under tropical grazing conditions.     

Anthropometric data in middle-aged women. The population study of women in G?teborg 1968-1969.

Body weight, body height, skinfolds, circumferences and weight indices in a population sample of 1462 women in ages between 38 and 60 years are presented. Significant age differences were noted. High correlations (r) were found between body weight and triceps and subscapular skinfolds (0.62 and 0.72 respectively) and between body weight and arm, waist and buttock circumferences (0.75-0.88). Age differences were mostly noted between 46 and 50 years of age. After that age there was a comparatively greater increase of the waist circumference than of the buttock circumference, while triceps skinfold seemed to decrease after the age of 50 indicating an altered adipose tissue distribution from the extremities to the trunk with increasing age. When taking data from a previous study of body weight in the same population of women into consideration it seems that the age differences in body weight found in cross-sectional study like the present one may to a large extent depend on differences between different cohorts studied.     

Secular trends of sizes at birth in Japanese healthy infants born between 1962 and 1988

Body sizes at birth are important clinical indicators widely used for evaluation of prenatal growth. Japan had significant socioeconomic improvement around the 1960s, and these environmental changes may influence physiologically prenatal growth. Furthermore, in Japan, measurements of size at birth for birth certificates are weight and height. Thus, we can refer to annual data on weight and height, but not on head and chest circumference at birth. In this study we measured the weight, height, and head and chest circumference at birth among 6,563 Japanese singleton healthy infants, annually in 1962 and 1988, and examined secular trends of these anthropometric measurements. The boys consistently exceeded the girls in all four variables. Birth weight and height increased significantly from the 1960s to '70s, but did not differ between the '70s and '80s in both boys and girls. Secular trends of head and chest circumference were different from them. In both boys and girls, head and chest circumference increased significantly from the '60s to the '70s, but decreased significantly from the '70s to the '80s. No difference of head circumference during the '60s and '80s was found, but the difference of chest circumference was found. Size at birth was likely to increase from the '60s to '70s in Japan. These findings suggest that the environmental changes such as socioeconomic improvements influence the prenatal growth.     

The polymorphism in insulin receptor substrate-1 gene and birth weight in neonates at term

BACKGROUND: The mutation of the IRS-1 gene is one of the genetic risk factors which, it is speculated, is associated with insulin resistance or predisposition to type 2 diabetes. The aim of our study was to evaluate the association between the Gly972Arg polymorphism in the IRS-1 gene and birth weight in newborn children with adequate gestational age. MATERIAL AND METHODS: 100 newborn children with adequate gestational age (38-42 weeks), whose mother had no disorders during pregnancy, were studied. Genomic DNA was extracted from umbilical cord blood leukocytes, and Gly972Arg polymorphism in the IRS-1 gene was genotyped using the PCR-based method. RESULTS: Birth weight was significantly lower in the newborn with the IRS-1 Gly972Arg polymorphism compared with a control group (3161.75 +/- 380.86 g vs. 3427.92 +/- 468.86 g). Body length and head circumference at birth were also lower in the neonates with that polymorphism (54.38 +/- 3.13 cm vs. 52.69 +/- 2.91 cm, and 34.08 +/- 1.47 vs. 33.63 +/- 0.81, respectively). CONCLUSIONS: The results suggest that the Gly972Arg genotype is associated with lower birth weight, body length and head circumference in neonates with adequate gestational age.     

Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort

ObjectiveTo investigate whether size at birth and rate of fetal growth influence the risk of breast cancer in adulthood.DesignCohort identified from detailed birth records, with 97% follow up.SettingUppsala Academic Hospital, Sweden.Participants5358 singleton females born during 1915-29, alive and traced to the 1960 census.ResultsSize at birth was positively associated with rates of breast cancer in premenopausal women. In women who weighed ⩾4000 g at birth rates of breast cancer were 3.5 times (95% confidence interval 1.3 to 9.3) those in women of similar gestational age who weighed <3000 g at birth. Rates in women in the top fifths of the distributions of birth length and head circumference were 3.4 (1.5 to 7.9) and 4.0 (1.6 to 10.0) times those in the lowest fifths (adjusted for gestational age). The effect of birth weight disappeared after adjustment for birth length or head circumference, whereas the effects of birth length and head circumference remained significant after adjustment for birth weight. For a given size at birth, gestational age was inversely associated with risk (P=0.03 for linear trend). Adjustment for markers of adult risk factors did not affect these findings. Birth size was not associated with rates of breast cancer in postmenopausal women.ConclusionsSize at birth, particularly length and head circumference, is associated with risk of breast cancer in women aged <50 years. Fetal growth rate, as measured by birth size adjusted for gestational age, rather than size at birth may be the aetiologically relevant factor in premenopausal breast cancer.

What is already known on this topic

There is some evidence that birth weight is related to risk of breast cancerThe exact nature of any association and whether it differs at premenopausal and postmenopausal ages is unclearFew studies have examined the effect of other measures of birth size and of gestational age

What this study adds

There are strong positive associations between measures of birth size and rates of breast cancer at premenopausal ages that persisted after adjustment for adult risk factorsFor a given birth size, gestational age was inversely associated with risk, suggesting that the rate of fetal growth may be aetiologically relevant to premenopausal breast cancerThere was no association between birth characteristics and rates of breast cancer at postmenopausal ages