Presented as a poster at the Neonatal Society 2016 Summer Meeting.
Kage A, Cowan F, Kempley S, Finer S, Hogg M, Hitman G, Shah DK
Royal London Hospital, Imperial College, London, Queen Mary University of London, UK
Background: Head circumference (HC) is routinely used as a parameter of head growth, often reflecting the underlying brain growth as well as overall nutritional status during infancy. Hypothesis: Head circumference correlates with linear measurements of cerebral structures taken using cranial Ultrasound. Objectives: 1) To correlate head circumference with linear measurement of cerebral structures using cranial Ultrasound (CUS). 2) To establish reference ranges for various cerebral measurements using cranial ultrasound in term infants from a local population.
Methods: Newborn infants of South Asian origin born at gestation above 36 weeks of South Asian origin were prospectively recruited after birth at the Royal London Hospital. HC was measured three times at the time of CUS, with a paper tape and the average calculated. Linear measurements were carried out “off-line” after CUS images were acquired using the method described by Hagmann et al (1). Correlations between cerebral measurements and gestational age (GA), head circumference (HC) and birth weight (BW) were carried out using SPSS (version 22, Armonk, NY: IBM Corp).
Results: Images were obtained for 66 infants (median gestational age of 39weeks). Significant correlations were found between corpus callosum (CC) length and BW (p=0.02), CC length and HC (p=0.01), bi-parietal diameter (BPD) and HC (p=0.05), gestation and cerebellar vermis (CV) height (p=0.02) and gestation and BPD (p=0.02). After adjusting for birth weight, there was a persistent significant correlation between transverse cerebellar diameter and head circumference (p=0.04). Males had larger transverse cerebellar diameter (p=0.03) and cerebellar vermis height (p=0.006) when compared to female infants. Intra and inter-observer agreement was substantial/excellent.
Conclusion: Baseline measurements of multiple cerebral components were obtained using CUS; providing reference values for this local population. Head circumference remains a simple and effective tool with a good correlation between this measure of head growth and corpus callosum length, bi-parietal and transverse cerebellar diameters.
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1. Hagmann et al. Early Hum Dev. 2011 May;87(5):341-7