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Background: Newborns are shaped by prenatal maternal experiences. These include a pregnant person's physical health, prior pregnancy experiences, emotion regulation, and socially determined health markers. We used a series of machine learning models to predict markers of fetal growth and development—specifically, newborn birthweight and head circumference (HC). Methods: We used a pre-registered archival data analytic approach. These data consisted of maternal and newborn characteristics of 594 maternal-infant dyads in the western U.S. Participants also completed a measure of emotion dysregulation. In total, there were 22 predictors of newborn HC and birthweight. We used regularized regression for predictor selection and linear prediction, followed by nonlinear models if linear models were overfit. Results: HC was predicted best with a linear model (ridge regression). Newborn sex (male), number of living children, and maternal BMI predicted a larger HC, whereas maternal preeclampsia, number of prior preterm births, and race/ethnicity (Latina) predicted a smaller HC. Birthweight was predicted best with a nonlinear model (support vector machine). Occupational prestige (a marker similar to socioeconomic status) predicted higher birthweight, maternal race/ethnicity (non-White and non-Latina) predicted lower birthweight, and the number of living children, prior preterm births, and difficulty with emotional clarity had nonlinear effects. Conclusions: HC and birthweight were predicted by a variety of variables associated with prenatal stressful experiences, spanning medical, psychological, and social markers of health and stress. These findings may highlight the importance of viewing prenatal maternal health across multiple dimensions. Findings also suggest that assessing difficulties with emotional clarity during standard obstetric care (in the U.S.) may help identify risk for adverse newborn outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Maternal smoking during pregnancy and gestational diabetes mellitus (GDM) have opposite effects on fetal growth during pregnancy. The aim of the study was to evaluate the interaction of smoking during pregnancy and gestational diabetes mellitus on head circumference and birthweight of newborns. Material and Methods: The study included all primiparous women with singleton pregnancies (n = 290 602) without previously diagnosed diabetes or hypertension in Finland between 2006 and 2018. The information on gestational diabetes mellitus, newborn birthweight and head circumference, and maternal smoking and backgrounds was derived from the Finnish Medical Birth Register. Linear regression models were used in the analyses. Results: In total 8.0% of parturients quit smoking during the first trimester and 9.9% continued smoking thereafter. The prevalence of GDM was 8.9% (n = 25 948). Newborns of women who continued smoking had a smaller head circumference (b = −0.24, SE = 0.01, p < 0.0001) and birthweight (b = −0.28, SE = 0.01, p < 0.0001) compared to newborns of women who did not smoke. Head circumference and birthweight were greater in newborns of women with GDM (b = 0.09, SE = 0.01, p < 0.0001 and b = 0.16, SE = 0.01, p < 0.0001, respectively) compared to newborns of women without GDM. In the interaction analyses, head circumference (b = −0.13, SE = 0.01, p < 0.0001) was smaller and birthweight (b = −0.13, SE = 0.02, p < 0.0001) was lower in newborns of women with GDM who continued smoking compared to newborns of women without GDM who did not smoke. Conclusions: Although smoking and GDM have opposite effects on fetal growth, the negative effects of exposure to smoking are also seen in newborns of women with GDM. Compared to smoking after the first trimester of pregnancy, cessation of smoking during the first trimester was associated with greater head circumference and birthweight in newborns. [ABSTRACT FROM AUTHOR]

Aim: To assess inpatient growth parameter trajectories and to identify the type of opioid exposure and treatment characteristics influencing growth parameters of infants admitted to the newborn intensive care unit (NICU) for pharmacological treatment of neonatal opioid withdrawal syndrome (NOWS). Methods: Charts of term infants with NOWS admitted to NICU from 2012 to 2019, who received pharmacologic treatment, were reviewed. Intake (volume: mL/kg/day; calorie: kcal/kg/day) and growth parameter trajectories (weight, head circumference, and length) were analyzed based on the type of prenatal opioid exposure (short‐acting opioids (SAOs), long‐acting opioids (LAOs), and polysubstance), pharmacologic treatment, and sex. Growth measurement patterns over time were compared between groups using longitudinal mixed‐effects models. Results: One hundred nineteen infants were included in the study with median birth weight Z‐score of −0.19 at birth and decreased to a median of −0.72 at discharge. Exposure to SAO was associated with an increase in Z‐scores nearing discharge across all growth parameters (Z‐score for weight p = 0.03). Polysubstance exposure was associated with a decrease in Z‐scores for length and head circumference throughout hospitalization. Infants with adjunct clonidine treatment had an increase in Z‐score for weight trends. Male infants had a decrease in Z‐scores for weight (male −0.96, female −0.59, interaction p = 0.06) and length (male −1.17, female −0.57, interaction p = 0.003) at Day 28. Despite the difference in growth trajectories, intake in terms of amount (mL/kg/day) and calorie intake (kcal/kg/day) was similar based on prenatal exposure, treatment, and sex. Conclusion: Infants with NOWS requiring pharmacologic treatment have a decrease in Z‐scores for weight, length, and head circumference at birth and at hospital discharge. Infants with prenatal polysubstance exposure were at particular risk for poorer inpatient growth relative to infants exposed to SAO and LAO, indicated by lower Z‐scores for length and occipital frontal circumference (OFC). [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion In the context of adverse in utero environments, the fetal brain might be preserved at the expense of other tissues. This trade‐off, brain sparing, has not been studied in the context of maternal infection. We investigated cases of maternal syphilis in the early 20th century and influenza during the 1918–1920 pandemic, in the Swiss city of Lausanne, a relatively high‐income setting. We tested the brain sparing hypothesis, that head circumference is protected at the expense of birth weight.A total of 8530 individual birth records from 1911 to 1922 from the University Maternity Hospital of Lausanne were used. We fitted generalized linear and additive linear models to explain how neonatal size varies under disease exposure.Influenza reduced head circumference and birth weight among livebirths similarly, by −0.11 and −0.14 standard deviation (SD) units respectively. Conversely, for syphilis‐exposed infants, head circumference was affected more than birth weight (−0.61 SD vs. −0.46 SD). Stillborn infants exposed to syphilis experienced a much greater reduction in head circumference (−1.92 SD) than liveborn infants. After adjustment for gestational age, these findings persisted in the case of influenza, but the effects of syphilis were reduced. Furthermore, half of syphilis‐exposed infants were born before term, suggesting that lower infant size was partly mediated by shorter gestation. Nevertheless, head circumference among stillbirths exposed to syphilis was still substantially reduced, even after adjustment for gestational age (−1.26 SD).Our findings do not support the brain sparing hypothesis. Moreover, the substantial reduction in head circumference among syphilis‐exposed fetuses might help explain why a quarter of them were stillborn. [ABSTRACT FROM AUTHOR]

Background/Objectives: To evaluate the quality of an ultrasound practice, both large-scale and focused audits are recommended by professional organizations, but such audits can be time-consuming, inefficient, and expensive. Our objective was to develop a time-efficient, quantitative, objective, large-scale method to evaluate fetal biometry measurements for an entire practice, combined with a process for focused image review for personnel whose measurements are outliers. Methods: Ultrasound exam data for a full year are exported from commercial ultrasound reporting software to a statistical package. Fetal biometry measurements are converted to z-scores to standardize across gestational ages. For a large-scale audit, sonographer mean z-scores are compared using analysis of variance (ANOVA) with Scheffe multiple comparisons test. A focused image review is performed on a random sample of exams for sonographers whose mean z-scores differ significantly from the practice mean. A similar large-scale audit is performed, comparing physician mean z-scores. Results: Using fetal abdominal circumference measurements as an example, significant differences between sonographer mean z-scores are readily identified by the ANOVA and Scheffe test. A method is described for the blinded image audit of sonographers with outlier mean z-scores. Examples are also given for the identification and interpretation of several types of systematic errors that are unlikely to be detectable by image review, including z-scores with large or small standard deviations and physicians with outlier mean z-scores. Conclusions: The large-scale quantitative analysis provides an overview of the biometry measurements of all the sonographers and physicians in a practice, so that image audits can be focused on those whose measurements are outliers. The analysis takes little time to perform after initial development and avoids the time, complexity, and expense of auditing providers whose measurements fall within the expected range. We encourage commercial software developers to include tools in their ultrasound reporting software to facilitate such quantitative reviews. [ABSTRACT FROM AUTHOR]

BACKGROUND: - The correlation between height and head circumference has been the subject of numerous studies, with researchers aiming to understand how these two measurements relate to each other throughout different stages of life. AIM AND OBJECTIVES: - To study the relationship of human height with human head circumference MATERIAL AND METHODS: - The present study was carried out in Government Medical College Srinagar for a period of three months from January 2024 to March 2024. One hundred (50 males; 50 females) healthy individuals between 18-36 years of age and of Indian origin were randomly selected for this study. RESULTS: - The mean height of males observed was 172.01 ± 7.46 cm. The mean height of females observed was 160.30 ± 5.23 cm. It was observed that height of males was more than the height of females. The mean value of head circumference in males observed was 56.83 ± 2.16 cm. The mean value of head circumference in females observed was 54.90 ± 10.38 cm. It was also observed that there is positive correlation between height and head circumference and this correlation was found statistically significant. CONCLUSION: - Our study showed that there is positive correlation between height and head circumference and this correlation was found statistically significant. [ABSTRACT FROM AUTHOR]

Purpose: Labor is shorter in multiparous women. However, there are no individualized data on differences in duration of labor for consecutive deliveries in the same parturient. Methods: We conducted a retrospective data analysis from 2004 to 2021 at the University Hospital of Zurich and included all women with 2 or more vaginal deliveries of a singleton child in cephalic position, between 22 and 42 weeks of gestation. Descriptive statistics were performed with SPSS version 25.0 (IBM, SPSS Inc., USA). The primary endpoint was the ratio between durations of labor stages in consecutive deliveries of the same parturient. Results: A total of 3344 women with 7066 births (2601 first [P0], 2987 s [P1], 1176 third [P2], and 302 fourth [P3]) were included. The ratio of duration of the active first stage of labor between P1 and P0 was 0.49 (95% CI 0.47–0.51, p < 0.001) meaning that the active first stage of labor was 51% shorter. The second stage of labor with a ratio of 0.26 (95% CI 0.24–0.27, p < 0.001) was 74% shorter in P1 compared to P0. Higher birthweight of the first child led to an even greater decrease in duration of the second stage of labor in P1 compared to P0 (p = 0.003). Neuraxial anesthesia was an independent risk factor for a longer duration of labor, irrespective of parity (p < 0.001). Birthweight and HC of the neonates did not significantly differ between the children born by the same women. However, higher birthweight in of the first child significantly augmented the rate of second stage of labor between P0 and P1 (p = 0.003). Discussion: Up to the third delivery, duration of labor decreased with each consecutive delivery of the same parturient. An individualized assessment of the expected duration of labor in multiparous women should be encouraged. [ABSTRACT FROM AUTHOR]

Anthropometric measures at birth, indexing prenatal growth, are associated with later cognitive development. Children in low- and middle-income countries (LMIC) are at elevated risk for impaired prenatal and early postnatal growth and enduring cognitive deficits. However, the associations of neonatal physical growth with neural activity are not well-characterized in LMIC contexts, given the dearth of early childhood neuroimaging research in these settings. The current study examined birth length, weight, and head circumference as predictors of EEG relative power over the first three years of life in rural Limpopo Province, South Africa, controlling for postnatal growth and socioeconomic status (SES). A larger head circumference at birth predicted lower relative gamma power, lower right hemisphere relative beta power, and higher relative alpha and theta power. A greater birth length also predicted lower relative gamma power. There were interactions with timepoints such that the associations of birth head circumference and length with EEG power were most pronounced at the 7-month assessment and were attenuated at the 17- and 36-month assessments. The results identify birth head circumference and length as specific predictors of infant neural activity within an under-resourced context. [ABSTRACT FROM AUTHOR]

Introduction: The inaccuracy of late pregnancy dating is often discussed, and the impact on diagnosis of fetal growth restriction is a concern. However, the magnitude and direction of this effect has not previously been demonstrated. In this study, we aimed to investigate the effect of late pregnancy dating by head circumference on the detection of late onset growth restriction, compared to first trimester crown‐rump length dating. Material and methods: This was a cohort study of 14 013 pregnancies receiving obstetric care at a tertiary center over a three‐year period. Universal scans were performed at 12 weeks, including crown‐rump length; at 20 weeks including fetal biometry; and at 36 weeks, where biometry, umbilical artery doppler and cerebroplacental ratio were used to determine the incidence of fetal growth restriction according to the Delphi consensus. For the entire cohort, the gestational age was first calculated using T1 dating; and was then recalculated using head circumference at 20 weeks (T2 dating); and at 36 weeks (T3 dating). The incidence of fetal growth restriction following T2 and T3 dating was compared to T1 dating using four‐by‐four sensitivity tables. Results: When the cohort was redated from T1 to T2, the median gestation at delivery changed from 40 + 0 to 40 + 2 weeks (p < 0.001). When the cohort was redated from T1 to T3, the median gestation at delivery changed from 40 + 0 to 40 + 3 weeks (p < 0.001). T2 dating resulted in fetal growth restriction sensitivity of 80.2% with positive predictive value of 78.8% compared to T1 dating. T3 dating resulted in sensitivity of 8.6% and positive predictive value of 27.7%, respectively. The sensitivity of abnormal CPR remained high despite T2 and T3 redating; 98.0% and 89.4%, respectively. Conclusions: Although dating at 11–14 weeks is recommended, late pregnancy dating is sometimes inevitable, and this can prolong the estimated due date by an average of two to three days. One in five pregnancies which would be classified as growth restricted if the pregnancy was dated in the first trimester, will be reclassified as nongrowth restricted following dating at 20 weeks, whereas nine out of 10 pregnancies will be reclassified as non‐growth restricted with 36‐week dating. [ABSTRACT FROM AUTHOR]

Introduction: Cleft Lip (CL) and Cleft Palate (CP) are associated with several complications that have a significant negative impact on the Quality of Life (QoL) of affected children and caregivers. Compared to their healthy counterparts, children with these conditions experience feeding difficulties, cosmetic abnormalities, and, most importantly, diminished physical and cognitive growth, especially during the first year of their lives. Aim: To evaluate the growth parameters in CL and/or CP infants and the QoL of parents with a CL and/or CP child before and after primary surgery. Materials and Methods: For this observational study, data was collected longitudinally from the same set of Cleft lip and cleft palate (CL/CP)/CL&CP infants and their parents before and after the primary surgery. The study was conducted at the Department of Paediatric and Preventive Dentistry, Guru Nanak Institute of Dental Sciences and Research, West Bengal, ABMSS Kolkata Comprehensive Cleft Care Centre, West Bengal, and IMA Vaccination Centre Barasat, West Bengal, India, from December 2020 to May 2022. In this study, 66 children and 64 parents were included in each study and control group. Growth parameters {weight, length, Head Circumference (HC)} were measured using a weight analogue machine, infantometer, and HC measuring tape, and compared with those of healthy infants. The QoL of parents with CL and/or CP infants was quantified using a questionnaire form of "Revised Impact on Family Scale (RIOFS)" filled out by parents before and after six months of primary surgery and compared with the QoL of same-age healthy infants. The responses to the RIOFS questionnaire were scored according to recommended guidelines. The Statistical Package for Social Sciences (SPSS) Statistics 23.0 was used for data analysis. Results: Among the study groups, statistically significant differences in mean height, weight, and HC were observed between the groups of all infants with CL, CP, and CL with CP before and after the primary surgery (p<0.001). The QoL of parents from the study group improved post-surgery. The difference in mean RIOFS score between study Group-3 and study Group-4 after the primary surgery was statistically significant (p<0.001). Conclusion: The growth of CL and/or CP infants and the QoL of their caregivers are compromised compared to healthy infants. After primary surgery, the growth of CL and/or CP infants and the QoL of their parents partially improved. [ABSTRACT FROM AUTHOR]

Purpose: Intraventricular hemorrhage (IVH) of prematurity can lead to hydrocephalus, sometimes necessitating permanent cerebrospinal fluid (CSF) diversion. We sought to characterize the relationship between head circumference (HC) and ventricular size in IVH over time to evaluate the clinical utility of serial HC measurements as a metric in determining the need for CSF diversion. Methods: We included preterm infants with IVH born between January 2000 and May 2020. Three measures of ventricular size were obtained: ventricular index (VI), Evan's ratio (ER), and frontal occipital head ratio (FOHR). The Pearson correlations (r) between the initial (at birth) paired measurements of HC and ventricular size were reported. Multivariable longitudinal regression models were fit to examine the HC:ventricle size ratio, adjusting for the age of the infant, IVH grade (I/II vs. III/IV), need for CSF diversion, and sex. Results: A total of 639 patients with an average gestational age of 27.5 weeks were included. IVH grade I/II and grade III/IV patients had a positive correlation between initial HC and VI (r = 0.47, p < 0.001 and r = 0.48, p < 0.001, respectively). In our longitudinal models, patients with a low-grade IVH (I/II) had an HC:VI ratio 0.52 higher than those with a high-grade IVH (p-value < 0.001). Patients with low-grade IVH had an HC:ER ratio 12.94 higher than those with high-grade IVH (p-value < 0.001). Patients with low-grade IVH had a HC:FOHR ratio 12.91 higher than those with high-grade IVH (p-value < 0.001). Infants who did not require CSF diversion had an HC:VI ratio 0.47 higher than those who eventually did (p < 0.001). Infants without CSF diversion had an HC:ER ratio 16.53 higher than those who received CSF diversion (p < 0.001). Infants without CSF diversion had an HC:FOHR ratio 15.45 higher than those who received CSF diversion (95% CI (11.34, 19.56), p < 0.001). Conclusions: There is a significant difference in the ratio of HC:VI, HC:ER, and HC:FOHR size between patients with high-grade IVH and low-grade IVH. Likewise, there is a significant difference in HC:VI, HC:ER, and HC:FOHR between those who did and did not have CSF diversion. The routine assessments of both head circumference and ventricle size by ultrasound are important clinical tools in infants with IVH of prematurity. [ABSTRACT FROM AUTHOR]

• Fetuses with a small HC without structural anomalies on second trimester expert ultrasound require follow-up and special medical attention Female fetuses are more likely to be diagnosed with a small head circumference. • Genetic diagnostic testing (microarray) should be included in the prenatal counseling. • WES counseling by a geneticist could be considered. To evaluate perinatal and postnatal outcomes of fetuses with an isolated small head circumference (HC) on expert ultrasound examination in the second trimester for further recommendations in prenatal care. In a retrospective cohort we included singleton-pregnancies with a fetal HC > −3.0 SD and ≤ −1.64 SD determined on expert ultrasound examination between 18 and 24 weeks of gestational age. Three subgroups were determined: "isolated small HC (ISHC)", "small HC plus abdominal circumference (AC) ≤ p10 (SHC+)" and "small HC plus AC ≤ p10 and Doppler abnormalities (SHC + D)". After ultrasound examination, genetic testing was sometimes offered and postnatally genetic tests were performed on indication. We included 252 pregnancies: 109 ISHC, 104 SHC+, and 39 SHC + D. In the ISHC and SHC+ subgroup, 96 % of the fetuses were born alive and did not die neonatal. In the SH + D group this was only 38 %. In the SHC+ subgroup, less fetuses were delivered vaginal (non-instrumental) compared to the ISHC subgroup (61 % vs. 73 %, p < 0.01). In the ISHC and SHC+ subgroup s some fetuses were diagnosed with congenital defects (4 % vs. 10 %, p = 0.08) and with a genetic anomaly (6.4 % vs. 7.7 %, p = 0.13) after 24 weeks or postnatally. In SHC + D subgroups 5 % presented with congenital defects and 2.6 % with a genetic anomaly. We conclude that fetuses with a small HC without structural anomalies on second trimester expert ultrasound require follow-up and special medical attention. We recommend differentiating between ISHC, SHC+, and SHC + D for prenatal counseling. Genetic testing and referral to a clinical geneticist should be considered. [ABSTRACT FROM AUTHOR]

• Small fetal HC that are less than −3 SD is associated with genetic variants, especially those with intracranial anomalies. • Fetuses with small head that do not reach the diagnosis criteria of microcephalycan't be simply explained as part of FGR. • Genetic variants, mainly CNV and SNV, can explain a substantial proportion of small fetal HC and most them are de novo. • CMA is practical for testing fetuses with small HC, and WES is more effective for genetic testing. • The novel findings about microcephaly-associated genes add value to the clinical use of exome sequencing in this population. • These findings help with the prenatal diagnosis of suspected fetal microcephaly and distribute to our clinical counselling. Objectives: To comprehensively evaluate the contributions of numerical chromosomal abnormality, copy number variant (CNV), and sequence variant (SV) to fetuses with small head circumference in a Chinese cohort using chromosome microarray analysis and whole exome sequencing. Methods: A total of 157 fetuses with small heads defined as head circumference < − 2 standard deviation (SD) were recruited between October 2014 and March 2023. We used the ultrasonic measurement parameter Z-score to define small head as possible microcephaly (3 < Z ≤ -2), microcephaly (-5 < Z ≤ -3), or pathologic microcephaly (Z ≤ -5). Ultrasound findings and genetic results were analyzed. Results: The overall diagnostic yield of chromosomal abnormalities by microarray analysis was 13 %. Whole exome sequencing revealed eight novel variants and two interesting candidate genes and provided a 25.4 % incremental yield compared with microarray analysis. Of the detected SVs, 56 % were de novo and the most common inheritance pattern was autosomal dominant inheritance presented in 11/16 fetuses. Compared with isolated small heads, non-isolated small heads had a significantly higher detection rate of chromosomal abnormalities (16 % vs. 3.0 %, P = 0.049) but not SVs (24 % vs. 5.5 %, P = 0.126). Subgroup analysis showed that intracranial anomalies had a similar high detection rate of SVs in fetuses with all small heads subgroups while no chromosomal abnormalities and causative SVs were found in fetuses with isolated possible microcephaly. Conclusions: Ultrasound findings of small fetal head circumference < 3 SD below the mean, especially those with intracranial structural abnormalities, indicate the need for genetic counseling. Genetic variants, mainly copy number variants and SV, may be responsible for the substantial proportion of small fetal head circumference, while most are de novo. Whole exome sequencing and microarray analysis are effective diagnostic approaches for this population. [ABSTRACT FROM AUTHOR]

Objective: To assess the reproducibility of ultrasound measurements of fetal biometry using a 'focus point' to assist the acquisition of the relevant plane. Methods: This was a study of 80 women with a singleton non‐anomalous pregnancy who attended University College London Hospital, London, UK, between 18 and 37 weeks' gestation. Planes to measure head circumference (HC), abdominal circumference (AC) and femur length (FL) were obtained four times by two different sonographers with different levels of experience, who were blinded to one another; the first set of images was obtained with reference to a standard image, and the second set of images was obtained using the focus point technique. The focus point was defined as a unique fetal anatomical landmark in each plane (cavum septi pellucidi for HC, two‐thirds of the umbilical vein for AC and one of the two extremities of the diaphysis for FL). Once identified, the focus point was maintained in view while the sonographer rotated the probe along three axes (x, y, z) to acquire the relevant plane. Sonographers were either in training or had > 3000 scans worth of experience. Intra‐ and interobserver reproducibility were assessed using Bland–Altman plots, and absolute values and percentages for mean difference and 95% limits of agreement (LoA) were reported. Results: Overall reproducibility was good, with all 95% LoA < 8%. Reproducibility was improved by use of the focus point compared with the standard technique for both intraobserver comparison (95% LoA, < 4% vs < 6%) and interobserver comparison (95% LoA, < 7% vs < 8%). These findings were independent of sonographer seniority and plane acquired. Conclusions: Reproducibility of fetal biometry assessment is improved with use of the focus point for plane acquisition, regardless of sonographer experience. We propose that this method should be implemented in clinical practice and training programs in fetal biometry. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This was a secondary analysis of a prenatal mindfulness training (MT) RCT versus treatment as usual (TAU) on neutrophil-to-lymphocyte ratio (NLR), a measure of maternal inflammation, and fetal head circumference. Fifteen participants were randomized to MT and 14 to TAU. NLR in third trimester was significantly lower in the MT group (F = 7.11, p = 0.019) relative to those in TAU. Higher NLR values in second (r = −0.644, p = 0.013) and third trimesters (r = −0.601, p = 0.030) were associated with lower fetal HC%. There was no group difference in fetal HC%. A future, fully powered study is needed to replicate these findings. Clinical Trials Number: NCT03679117 [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between head length, head circumference, and height in females of upper Punjab because cranial measurements are a more accurate and dependable way of estimating stature. Study Design: Descriptive Cross-sectional. Setting: Upper Punjab CMH Kharian Medical College. Period: May 2022 to May 2023. Material & Methods: This descriptive cross-sectional research involved n=382 females in upper Punjab who were between the ages of 20 and 25. A distributing calliper and a non-elastic tape were used to measure the head’s length and circumference, respectively. A common height measuring tool was used to measure height. The female’s height and head circumference were both measured in centimetres. The collected data were analysed to determine the relationship between head circumference and height as well as head length and height. For the statistical information, Pearson’s correlation coefficient was used, and data were analysed. Results: Head length and height were shown to be significantly positively correlated (r=0.518, p<0.001). Height and head circumference were shown to have a substantial positive connection (r=0.344). Conclusion: In the current research, it was found that in females from upper Punjab, there had been a substantial positive association between height and head length, showing that head length is a trustworthy predictor in estimating height. Additionally, there was a significant positive relationship between females’ head circumference and height. [ABSTRACT FROM AUTHOR]

Introduction: Fetal growth may be affected by both maternal polycystic ovary syndrome (PCOS) and metformin therapy. Here, we explore the effect of intrauterine metformin exposure on birth anthropometrics of infants born to women with PCOS. We also investigated whether the effect of metformin on birth anthropometrics is modified by maternal pre‐pregnancy body mass index, PCOS hyperandrogenic phenotype, serum androgen levels, preconception use of metformin and offspring sex. Additionally, we assessed newborn anthropometrics in relation to a national reference population. Material and methods: Individual data from three randomized controlled triasl were pooled. The randomized controlled trials investigated the effects of metformin in pregnant women with PCOS. In all, 397 and 403 were randomized to the metformin and placebo groups, respectively. A Scandinavian growth reference was used to calculate sex and gestational age adjusted z‐scores. Linear regression models were used to estimate the effect of metformin on offspring z‐scores of head circumference, birth length, birthweight, placental weight, body mass index, ponderal index and birthweight:placental weight ratio. S‐testosterone, s‐androstenedione, and s‐sex‐hormone binding globulin from four timepoints in pregnancy were analyzed. Results: Compared with the PCOS‐placebo group, newborns in the PCOS‐metformin group had larger head circumference (head circumference z‐score: mean difference = 0.25, 95% CI = 0.11– 0.40). This effect of metformin on head circumference z‐score was particularly observed among offspring of overweight/obese mothers and mothers with hyperandrogenic PCOS‐phenotype. We observed no difference in other anthropometric measures between the metformin and placebo groups or any clear interaction between maternal androgen levels and metformin. Newborns in the PCOS‐placebo group were shorter than in the reference population (birth length z‐score: mean = −0.04, 95% CI = –0.05 to −0.03), but head circumference and birthweight were similar. Conclusions: Larger head circumference was observed at birth in metformin‐exposed offspring of mothers with PCOS. PCOS‐offspring were also shorter, with a similar birthweight to the reference population, indirectly indicating higher weight‐to‐height ratio at birth. [ABSTRACT FROM AUTHOR]

Background and objectives: It has long been known that airborne polycyclic aromatic hydrocarbons (PAHs) can negatively affect pregnancy and birth outcomes, such as birth weight, fetal development, and placental growth factors. However, similar studies yield divergent results. Our goal was to estimate the amount of monohydroxylated PAH (OH-PAH) metabolites in the urine of pregnant women/mothers and their newborns in relation to birth outcomes, such as placenta weight, Apgar 5', and the growth parameters of children up to the age of two. Methods: Two cohorts of children born in 2013 and 2014 during the summer and winter seasons in the Czech Republic in the cities Karviná (N = 144) and České Budějovice (N = 198), which differ significantly in the level of air pollution, were studied. PAH exposure was assessed by the concentration of benzo[a]pyrene (B[a]P) in the air and the concentration of 11 OH-PAH metabolites in the urine of newborns and mothers. Growth parameters and birth outcomes were obtained from medical questionnaires after birth and from pediatric questionnaires during the following 24 months of the child's life. Results: Concentrations of B[a]P were significantly higher in Karviná (p <0.001). OH-PAH metabolites were significantly higher in the mothers' as well as in the newborns' urine in Karviná and during the winter season. Neonatal length was shorter in newborns in Karviná (p <0.001), but this difference evened out during the next 3 to 24 months. Compared to České Budějovice, newborns in Karviná showed significantly lower weight gain between birth and three months after delivery. The OH-PAH metabolites in mothers' or newborns' urine did not affect birth weight. The presence of seven OH-PAH (top 25% of values of concentrations higher than the median) metabolites in the newborns' urine is associated with decreased length of newborn. Nine OH-PAH metabolites decreased placenta weight, which was the most significant, while seven OH-PAH metabolites decreased Apgar 5'. Conclusion: We have shown a possible connection between higher concentration of OH-PAH metabolites in newborns' urine and decreased length, head circumference, placenta weight, and Apgar 5', but not birth weight. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has introduced two sets of child growth standards for growth assessment. These reference values may not be suitable for use in other populations. Therefore, this study aimed to determine specific Z scores in the population covered by Mashhad University of Medical Sciences in Iran. Methods: This cross-sectional study was conducted on data obtained from the evaluation of height, weight, and head circumference of children aged from 0 to 18 months visiting the healthcare centers of Mashhad University of Medical Sciences from March 2018 to March 2021. A total data of 128,472 children were extracted from the Electronic Health Records (SinaEHR®) and included in the study. Finally, the collected data were analyzed using Minitab and SPSS software (version 16). Results: The L, M, and S parameters were used to calculate Z scores for weight, height, and head circumference. These Z scores were then compared to standard deviation values for each age from our study and international standards to determine any differences. Our study found that mean weight scores were 0.16 kg higher than the CDC standard and 0.34 kg higher than the WHO growth standard. Conclusion: The provision of this exclusive reference to children's growth indicators not only allows for a more accurate evaluation but also provides the possibility of comparison with other populations using their specific growth charts. It seems that one of the best plans is to compare growth charts with international populations and national growth charts, which due to the electronization of the entire processes of the health system, is more possible than ever. [ABSTRACT FROM AUTHOR]

Aim: The head circumference to chest circumference (HC/CC) ratio has been used to identify low birth weight infants in developed countries. This study was conducted to examine whether the ratio could distinguish asymmetrical foetal growth restriction (FGR). Methods: This retrospective observational study was conducted with 1955 infants (50.5% male) born at term between 2016 and 2020 at Tokyo Metropolitan Toshima Hospital, Japan. Results: We found that 120 (6.1%) had FGR. Their mean birth weight was 3052.1 ± 367.3 g, and their mean gestational age was 39.1 ± 1.1 weeks. Logistic regression analysis showed that the association between the HC/CC ratio and FGR had a regression coefficient of −20.6 (p < 0.000). The linear regression analysis showed that the association between the HC/CC ratio and the birth weight z‐score had a regression coefficient of −8.59 (p < 0.000). The coefficient of correlation was −0.33 (p < 0.001). The receiver operating characteristic curve for detecting FGR showed that the area under the curve was 0.75 and the cut‐off value was 0.93, with sensitivity of 75.8% and specificity of 60.8%. Conclusion: Our study established the associations between HC/CC ratio and FGR and birth weight z‐scores and confirmed that the ratio provided an easy way to detect FGR in term‐born infants. [ABSTRACT FROM AUTHOR]

Objectives: To ascertain whether head circumference can be utilized to estimate stature in students from the medical college in Peshawar. Methodology: In this study, we aimed to investigate the relationship between height and head circumference in a cohort of first-year students from a public medical college. The sample comprised 140 participants, evenly split between 70 males and 70 females, with ages ranging from 18 to 20 years. For height measurement a stadiometer was used, and a measuring tape was used to gauge head circumference. Regression equation was used to analyze the data for estimating height from circumference of head. Results: In this study, the average height of males was determined to be 174.860 cm with a standard deviation of 5.745 cm, while the average head circumference was 54.926 cm with a standard deviation of 1.590 cm. Conversely, females exhibited an average height of 160.842 cm with a standard deviation of 5.540 cm, and an average head circumference of 53.245 cm with a standard deviation of 1.286 cm. Conclusion: In conclusion, our study underscores the significance of head circumference as a reliable indicator for assessing stature in both males and females. The observed significant relationship between head circumference and height in both sexes suggests that head circumference can serve as a robust parameter for estimating height. These findings contribute to the field of anthropometry, providing practical implications for height estimation based on head circumference, and may have relevance in diverse contexts, such as clinical assessments or population studies. [ABSTRACT FROM AUTHOR]

Background: The human body dimensions are affected by ecological, geographical, racial, gender, and age factors. Craniofacial anthropometry has become an important tool used in genetic counseling, reconstructive surgery, and forensic medicine. Orbital measurements are important in the evaluation of several systemic syndrome, craniofacial abnormalities, and also surgical treatment of post-traumatic telecanthus. Among these measurements, normal interpupillary distance, inner canthal distance (ICD), and outer intercanthal distance are the vital features to be known. Aims and Objectives: The aims and objectives of the present study were to assess the ICD, head circumference (HC), and circumference orbital index of male and female medical students of North India and find out gender differences in the respective parameters and thus to contribute the present finding to the available literature. Materials and Methods: This was an observational descriptive study conducted in the department of anatomy at a fixed time in 150 MBBS course students in the age group 18-22 years. The ICD and HC were measured using round end digital spreading Vernier caliper. Then, circumference interorbital index (CII) was calculated and analyzed. Results: The mean ICD in males was 3.44±0.33 mm and in females was 3.21±0.32 mm; mean HC in males was 56.03±1.55 mm and in females was 53.88±1.38 mm; and mean CII in males was 6.15±0.54 and in females was 5.95±0.51. Conclusion: The result of this study will help to establish the mean values for of craniofacial anthropometric parameters for medical students of North India, and the results are showing that craniofacial anthropometric parameters are sexually dimorphic. [ABSTRACT FROM AUTHOR]

Owing to high rates of prenatal complications, twins are, on average, substantially smaller than population norms on physical measurements including height, weight, and head circumference at birth. By early childhood, twins are physically average. This study is the first to explore the process of catch-up growth by fitting asymptotic growth models to age-standardized height, weight, and head circumference measurements in a community sample of twins (n = 1281, 52.3% female) followed at up to 17 time points from birth to 15 years. Catch-up growth was rapid over the first year and plateaued around the population mean by early childhood. Shared environmental factors accounted for the majority of individual differences in initial physical size (57.7–65.5%), whereas additive genetic factors accounted for the majority of individual differences in the upper asymptotes of height, weight, and head circumference (73.4–92.6%). Both additive genetic and shared environmental factors were associated with variance in how quickly twins caught up. Gestational age and family SES emerged as important environmental correlates of physical catch-up growth. [ABSTRACT FROM AUTHOR]

Background: Achondroplasia is an autosomal dominant disorder mainly affecting bony growth, typically resulting in markedly short stature. From a neurosurgical viewpoint, patients sometimes develop spinal cord compression at the narrowed foramen magnum and hydrocephalus. This study aims to construct growth references for height, weight, and head circumference (HC) of young achondroplasia patients in Korea and to evaluate the predictability of the necessity and timing of neurosurgical procedures through growth patterns. Methods: Growth data were collected from achondroplasia patients who visited our institution between January 2002 and August 2022. First, we constructed percentile growth curves of height, weight, and HC for the patients under 3 years of age with the generalized additive model for location, scale, and shape (GAMLSS). Second, the growth patterns of the patients with hydrocephalus who underwent neurosurgical procedures such as foramen magnum decompression (FMD) and ventriculoperitoneal (VP) shunt were analyzed. Results: There were 125 achondroplasia patients, including 67 males and 58 females. Among 125 patients, 46 underwent FMD, and 5 underwent VP shunt. As short stature and macrocephaly were typical characteristics of achondroplasia, the height of achondroplasia was lower than that of the general population, and HC in achondroplasia showed accelerated growth postnatally. There were no significant changes in HC in hydrocephalus patients before they underwent neurosurgical procedures. The influence of hydrocephalus on the growth patterns of HC in achondroplasia seemed insignificant. Conclusion: Growth references for height, weight, and HC in young achondroplasia patients were constructed. It is the first report of growth patterns of achondroplasia in Korea. Unlike other pediatric patients, the diagnosis of hydrocephalus and the necessity of neurosurgical procedures are hard to be predicted with HC in achondroplasia. Neuroimaging should be considered for achondroplasia patients with neurological symptoms. [ABSTRACT FROM AUTHOR]

The global increase in the prevalence of ASD (Autism Spectrum Disorder) is of great medical importance, but the reasons for this increase are still unknown. This study sought to identify possible early contributing factors in children who were later diagnosed with ASD. In this retrospective cohort study, postnatal records of 1105 children diagnosed with ASD were analyzed to determine if any signs of ASD could be found in a large database of births and well-baby care programs. We compared the recordings of typically developing children and analyzed the differences statistically. Rapid increases in weight, height, and head circumference during early infancy predict the development of ASD. In addition, low birth weight, older maternal age, and increased weight and height percentiles at six months of age together predict the development of ASD. At two years of age, these four parameters, in addition to impaired motor development, can also predict the development of ASD. These results suggest that the recent increase in ASD prevalence is associated with the "obesity epidemic" and with recommendations of supine sleeping to prevent Sudden Infant Death Syndrome, associated with atypical neural network development in the brain. [ABSTRACT FROM AUTHOR]

Background: Massive subgaleal hematoma is defined as profuse bleeding in the subgaleal layer of the scalp, causing excessive accumulation of hematoma, thus progressively increasing the size of head circumference. If not immediately diagnosed and managed carefully, continuous bleeding will lead to hematoma enlargement, impairing the functions of surrounding organ(s) and general homeostasis. In severe cases, subgaleal hematoma could lead to severe morbidity or even death. Case report: We describe the case of an 11-year-old girl with a history of microcephaly and intellectual disability, presented with massive soft tissue swelling on more than half of her cranial circumference, accompanied with intermittent fever, anemia, and leukocytosis. The initial cerebral CT scan identified a mixed density extracranial lesion with multilobulated cystic appearance. The initial effort to aspirate the mass by a needle failed, and the patient was initially diagnosed with Pott's puffy tumor. Intraoperative findings confirmed the presence of massive subgaleal hematoma, and complete removal of the hematoma was achieved. The post-surgical period was uneventful, and the patient was discharged without any complications. Conclusion : Massive subgaleal hematoma should be considered in cases where children's head circumference increases rapidly, with or without a clear history of trauma and the presence of any possible risk factors. Missed diagnosis and inappropriate therapy could lead to unfavorable outcome. Hence, it is important for any clinicians to be familiar with this entity, so timely diagnosis and treatment can be made. [ABSTRACT FROM AUTHOR]

Abnormal brain growth in tuberous sclerosis complex (TSC) reflects abnormalities in cellular proliferation and differentiation and results in epilepsy and other neurological manifestations. Head circumference (HC) as a proxy for brain volume may provide an easily tracked clinical measure of brain overgrowth and neurological disease burden. This study investigated the relationship between HC and epilepsy severity in infants with TSC. Prospective multicenter observational study of children from birth to three years with TSC. Epilepsy data were collected from clinical history, and HC was collected at study visits at age three, six, nine, 12, 18, 24, and 36 months. Epilepsy severity was classified as no epilepsy, low epilepsy severity (one seizure type and one or two antiepileptic drugs [AEDs]), moderate epilepsy severity (either two to three seizure types and one to two AEDs or one seizure type and more than three AEDs), or high epilepsy severity (two to three seizure types and more than three AEDs). As a group, children with TSC had HCs approximately 1 S.D. above the mean World Health Organization (WHO) reference by age one year and demonstrated more rapid growth than the normal population reference. Males with epilepsy had larger HCs than those without. Compared with the WHO reference population, infants with TSC and no epilepsy or low or moderate epilepsy had an increased early HC growth rate, whereas those with severe epilepsy had an early larger HC but did not have a faster growth rate. Infants and young children with TSC have larger HCs than typical growth norms and have differing rates of head growth depending on the severity of epilepsy. [ABSTRACT FROM AUTHOR]

Newborn size at birth is an important indicator of fetal health, neonatal health, infant survival and childhood morbidity. The aim of our study was to assess and identify factors that significantly influence birth weight, length, and head circumference by performing a post hoc analysis of the data collected during the retrospective-prospective observational cohort study which was conducted at the Clinic for Gynecology and Obstetrics at the University Clinical Centre Kragujevac, Serbia. The influence of potential factors on birth weight, length, and head circumference was evaluated by multiple linear regression analysis. The study included 320 pregnant women and 332 newborns. Four factors had a significant negative effect on birth weight: smoking, twin pregnancy, use of methyldopa and corticosteroids during pregnancy. Smoking, twin pregnancy and corticosteroid use also had a significant negative effect on birth length. Negative effect on fetal head circumference at birth had smoking, use of corticosteroids and antibiotics during pregnancy. Maternal height and gestational age at birth showed a positive influence on fetal anthropometric measurements. Clinicians should pay attention to pregnant women with lower body height, twin pregnancy, who smoke and use corticosteroids, methyldopa and antibiotics. [ABSTRACT FROM AUTHOR]

Introduction: Fetal growth assessment by ultrasound is an essential part of modern obstetric care. The formula by Persson and Weldner for estimated fetal weight (EFW), used in Sweden since decades, has not yet been evaluated. The objective of this study was to evaluate accuracy and precision of the formula by Persson and Weldner, and to compare it to two other formulae using biparietal diameter instead of head circumference. Material and methods: The study population consisted of 31 521 singleton pregnancies delivered at 22+0 gestational weeks or later, with an ultrasound EFW performed within 2 days before delivery, registered in the Swedish Pregnancy Register between 2014 and 2021. Fetal biometric ultrasound measurements were used to calculate EFW according to the formulae by Persson and Weldner, Hadlock 2 and Shepard. Bland-Altman analysis, systematic error (mean percentage error), random error (standard deviation [SD] of mean percentage error), proportion of weight estimates within ±10% of birthweight, and proportion with underestimated and overestimated weight was calculated. Moreover, calculations were made after stratification into small, appropriate, and large for gestational age (SGA, AGA and LGA), respectively, and gestational age at examination. Results: For the formula by Persson and Weldner, MPE was -2.7 (SD 8.9) and the proportion of EFW within ±10% from actual birthweight was 76.0%. MPE was largest for fetuses estimated as severe SGA (<3rd percentile, -5.4) and for the most preterm fetuses (<24 weeks, -5.4). For Hadlock 2 and Shepard's formulae, MPE were 3.9 (SD 8.9) and 3.4 (SD 9.7), respectively, and the proportions of EFW within ±10% from actual birthweight were 69.4% and 67.1%, respectively. MPE was largest for fetuses estimated as severe LGA (>97th percentile), 7.6 and 9.4, respectively. Conclusions: The recommended Swedish formula by Persson and Weldner is generally accurate for fetal weight estimation. The systematic underestimation of EFW and random error is largest in extreme preterm and estimated SGA-fetuses, which is of importance in clinical decision making. The accuracy of EFW with the formula by Persson and Weldner is as good as or better than Hadlock 2 and Shepard's formulae. [ABSTRACT FROM AUTHOR]

Background: Determination of gestational age and expected date of delivery are important for maternal and fetal well-being. Most commonly used method is last menstrual period (LMP). To overcome the limitations of the LMP, ultrasonographic parameters are used. Objective: To study the correlation of gestational age based on LMP with various ultrasonographic parameters among healthy pregnant women. Methods: Hospital based cross-sectional study was carried out among 285 healthy pregnant women. LMP was determined by asking the women their last menstrual period and also cross-checked from the available records. The ultrasonographic parameters like biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) and transverse cerebellar diameter (TCD) were studied. Results: Majority of the women belonged to the age of 18-24 years (49.5%). Majority (41.4%) were primi. BPD, AC and TCD were positively correlated with gestational age by LMP (p<0.05). FL and HC were also positively correlated with gestational age by LMP but their coefficient of determination was not significant (p>0.05). For all parameters, as gestational age increased, their values also increased. Scatter plots of TCD, BPD and AC showed that there is a linear relation with the gestational age by LMP. But, the scatter plot of the HC and FL had no linear relation between the gestational age by LMP. Conclusion: The biparietal diameter, transverse cerebellar diameter and abdominal circumference showed a strong linear relationship with the gestational age by LMP. The FL and AC had no linear relation with it. [ABSTRACT FROM AUTHOR]

Phelan–McDermid syndrome (PMS) is a multisystem disorder that is associated with deletions of the 22q13 genomic region or pathogenic variants in the SHANK3 gene. Notable features include developmental issues, absent or delayed speech, neonatal hypotonia, seizures, autism or autistic traits, gastrointestinal problems, renal abnormalities, dolichocephaly, and both macro- and microcephaly. Assessment of the genetic factors that are responsible for abnormal head size in PMS has been hampered by small sample sizes as well as a lack of attention to these features. Therefore, this study was conducted to investigate the relationship between head size and genes on chromosome 22q13. A review of the literature was conducted to identify published cases of 22q13 deletions with information on head size to conduct a pooled association analysis. Across 56 studies, we identified 198 cases of PMS with defined deletion sizes and head size information. A total of 33 subjects (17%) had macrocephaly, 26 (13%) had microcephaly, and 139 (70%) were normocephalic. Individuals with macrocephaly had significantly larger genomic deletions than those with microcephaly or normocephaly (p < 0.0001). A genomic region on 22q13.31 was found to be significantly associated with macrocephaly with CELSR1, GRAMD4, and TBCD122 suggested as candidate genes. Investigation of these genes will aid the understanding of head and brain development. [ABSTRACT FROM AUTHOR]

Purpose: Head circumference (HC) is an important clinical tool for following head growth in children with craniosynostosis (CS). The purpose of this study is to quantify the usefulness of HC along continuum of CS care, from diagnosis to pre- and post-operative (pre-op, post-op) follow-up in Vietnamese children. Methods: A prospective cohort of 54 nonsyndromic single-suture CS patients undergoing open surgery from January 2015 to January 2020 was collected at Children's Hospital 2, Vietnam. HC z-score on admission was compared with World Health Organization (WHO) standards to evaluate for utility in initial diagnosis. Pre-op and post-op HC were compared to demonstrate the evolution of head growth following reconstruction. Results: Nonsyndromic single-suture CS was more predominant in males (79.6%) than in females (20.4%). The mean HC z-score was − 0.38 ± 1.29 similar to normal WHO standards regardless of which sutural involvement. The HC z-score increased above + 1 standard deviation (SD) significantly at 3 months of follow-up (p < 0.001); however, the trajectory gradually decreased after the first year of surgery. One patient (1.8%, 1/54) demonstrated restenosis and delayed intracranial hypertension (DIH) 4 years after reconstruction. Conclusions: The HC in nonsyndromic single-suture CS children presents similarly to the values of healthy children. Additionally, HC reliably increased after reconstruction and gradually normalized over subsequent years. This indicator is consistent in Southeast Asian populations and should be used to follow all patients to assess the normal progression of post-op head growth and as a useful indicator of suspected recurrent synostosis. [ABSTRACT FROM AUTHOR]

Microcephaly, characterized by crania with an abnormally small occipitofrontal circumference (OFC), is only sporadically described in paleopathological literature. Accurate identification of individuals suffering from microcephaly is challenging when performed in an archeological context, especially in mild cases, as appropriate reference data are often not available. This study aimed to describe the craniometric characteristics of the Meerenberg (MeB) skeletal collection and to identify microcephalic individuals while focusing on the diagnostic criteria and the influence of reference data on the prevalence of the condition. The value of virtual endocasts as a diagnostic tool was also assessed. Forty‐eight adults (1891–1936) excavated from the cemetery of the MeB psychiatric hospital (Bloemendaal, The Netherlands) were investigated. Microcephalic individuals were identified by using the craniometric characteristics of a contemporary Dutch archeological population as reference. In order to investigate the usefulness of modern clinical head circumference reference data on the diagnostic process, cranial OFCs of the MeB individuals were converted to head OFCs. Virtual endocasts were created from the identified microcephalics and three normocephalics. Three MeB females (all <−3 SD) were identified as microcephalic when compared with a sex‐matched contemporary archeological reference sample. The same three MeB females were classified as microcephalic when using sex‐matched modern clinical reference data and when applying −3 SD of the pooled sex archeological craniometric reference data as cut‐off point. No individuals were classified as microcephalic based on the metric characteristics of the virtual endocasts. Microcephaly can only be accurately identified when using sex‐matched contemporary population reference data, or in its absence, modern clinical data after soft tissue correction. Should sex estimation be unreliable, a –3 SD cut‐off point generated using pooled sex reference data seems suitable as diagnostic tool. Virtual endocast did not support the identification of microcephaly in this study. [ABSTRACT FROM AUTHOR]

Objective: Stagnation of skull growth is correlated with papilledema in craniosynostosis. In this retrospective cohort study, we describe the postoperative skull growth after surgical correction for sagittal synostosis and its relation to the development of papilledema. Methods : Patients with isolated sagittal synostosis at our center between 2005 and 2012 were included. Occipitofrontal circumference (OFC) was analyzed, at 3 time points (preoperative, 2 years postoperative, and last OFC measurement) and 3 phases (initial postoperative growth, long-term growth, and overall growth), and related to papilledema on fundoscopy. Results : In total, 163 patients were included. The first time interval showed a decline in skull growth, with subsequent stabilization at long term. Papilledema occurred postoperatively in 10 patients. In these patients, the OFC at 2 years and at last follow-up (T3) were significantly smaller than in patients without papilledema. A larger OFC resulted in a decreased odds of developing papilledema at both postoperative time points (at T2 (OR = 0.40, p = 0.01) and at T3 (OR 0.29, p < 0.001)). Sensitivity and specificity analysis indicated that an OFC below 0.25 SD at T2 (sensitivity 90%, specificity 65%) and below 0.49 at T3 (sensitivity 100%, specificity 60%) are related to the occurrence of papilledema. Conclusion: A small OFC is correlated with the occurrence of papilledema. A decline in OFC within 2 years postoperatively is common in sagittal synostosis and is acceptable up to a value of 0.25SD. Patients with an OFC at last follow-up of less than 0.5SD are at risk for developing papilledema. [ABSTRACT FROM AUTHOR]

Background: Head circumference (HC) correlates with brain growth and development. However, radiologists typically use their visual impressions to evaluate head dimensions, which is a purely subjective assessment. Objective: The first objective of this paper was to analyze whether it is possible to obtain HC measurements by CT and MRI cross-sectional volumetric imaging using parameters similar to the tape measurement method, which is considered the gold standard. The second objective was to determine the most accurate method for characterizing head size: visual impression or imaging measurement. Materials and methods: Children who underwent HC measurement by tape and with volumetric imaging exams were selected from the Paulo Niemeyer State Brain Institute, Brazil. Two radiologists classified the children's heads using their visual impressions and by direct measurement on imaging. We used anatomical parameters similar to the tape measurement method and appropriate head growth charts and compared the absolute values obtained. Results: The concordance between tape and imaging ranged 52.3–72.7% for visual impression (kappa 0.27–0.55), ≥ 95.5% for CT and ≥ 93.1% for MRI (kappa ≥ 0.92 and ≥ 0.88, respectively). Intraclass correlation coefficients ≥ 0.997 and ≥ 0.996, absolute technical error measurements of 0.20–0.31 cm and 0.24–0.29 cm, and relative technical error measurements of 0.49–0.73% and 0.58–0.70% were evidenced in the intra- and inter-rater evaluations, respectively. The means between the methods were not significantly different (P > 0.05), with high values of Pearson correlation coefficient (≥ 0.99) and Lin concordance correlation coefficient (≥ 0.99). Conclusion: Head circumference values obtained by cross-sectional volumetric imaging are similar to those obtained using the tape measurement method (gold standard), with high repeatability and reproducibility. Head size characterization by visual impression is less accurate than head circumference measurement by imaging and plotting the values obtained on World Health Organization normative charts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between the fetal head‐circumference‐to‐maternal‐height (HC/MH) ratio measured shortly before delivery and the occurrence of Cesarean section (CS) for labor dystocia. Methods: This was a multicenter prospective cohort study involving four tertiary maternity hospitals. An unselected cohort of women with a singleton fetus in cephalic presentation, at a gestational age beyond 36 + 0 weeks and without any contraindication for vaginal delivery, was enrolled between September 2020 and November 2021. The MH and fetal HC were measured on admission of the patient to the labor ward. The primary outcome of the study was the performance of the HC/MH ratio in the prediction of CS for labor dystocia. Women who underwent CS for any indication other than failed labor progression, including fetal distress, were excluded from the final analysis. Results: A total of 783 women were included in the study. Vaginal delivery occurred in 744 (95.0%) women and CS for labor dystocia in 39 (5.0%). CS for labor dystocia was associated with shorter MH (mean ± SD, 160.4 ± 6.6 vs 164.5 ± 6.3 cm; P < 0.001), larger fetal HC (339.6 ± 9.5 vs 330.7 ± 13.0 mm; P < 0.001) and a higher HC/MH ratio (2.12 ± 0.11 vs 2.01 ± 0.10; P < 0.001) compared with vaginal delivery. Multivariate logistic regression analysis showed that the HC/MH ratio was associated independently with CS for labor dystocia (adjusted odds ratio, 2.65 (95% CI, 1.85–3.79); P < 0.001). The HC/MH ratio had an area under the receiver‐operating‐characteristics curve of 0.77 and an optimal cut‐off value for discriminating between vaginal delivery and CS for labor dystocia of 2.09, which was associated with a sensitivity of 0.62 (95% CI, 0.45–0.77), specificity of 0.79 (95% CI, 0.76–0.82), positive predictive value of 0.13 (95% CI, 0.09–0.19) and negative predictive value of 0.98 (95% CI, 0.96–0.99). Conclusions: In a large cohort of unselected pregnancies, the HC/MH ratio performed better than did fetal HC and MH alone in identifying those cases that will undergo CS for labor dystocia, albeit with moderate predictive value. The HC/MH ratio could assist in the evaluation of women at risk for CS for labor dystocia. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Subgaleal hemorrhage (SGH) is a severe neonatal morbidity that is associated with vacuum-assisted delivery (VAD). Large sonographic head circumference (sHC) was previously associated with complicated VAD. Nevertheless, the association of large sHC with SGH formation following VAD is underreported. We aim to evaluate the role of sonographic head circumference (sHC) with SGH formation following attempted VAD. Methods: A retrospective case-control study. Cases comprised singleton pregnancies for whom attempted VAD resulted in SGH with an sHC measured within 2 weeks from delivery. Controls were VAD deliveries which not resulted in SGH, with an sHC measured within 2 weeks from delivery. We matched controls in a 1:1 ratio by gestational age, parity and year of delivery. Results: Overall, 118 women were included in the SGH study group and were matched to 118 controls. Baseline maternal and fetal characteristics were similar between the groups except for higher neonatal birth weight in the SGH group (median 3422 vs. 3195 grams, p = .001). sHC did not vary between groups (median 336 mm in SGH groups vs. 333, p = .08). Rate of sHC >90th and >95th percentile did not significantly differ between the groups (13.6% vs. 8.5%, 6.8% vs. 3.4%, p = .21, p = .37, for SGH vs. controls, respectively). In multivariate regression analysis, sHC was not found to be independently associated with SGH – aOR (95% CI) 1.004 (0.97–1.03). Receiver operating characteristic curves of sHC for SGH formation underlined an area under the curve of 0.58 (95% CI) (0.51–0.65). Conclusions: sHC is not associated with SGH formation following VAD. [ABSTRACT FROM AUTHOR]

Purpose: The purpose is to study the association of the fetal sonographic head circumference (SHC) with trial of labor after cesarean (TOLAC) success rate, among women with no prior vaginal deliveries. Methods: A retrospective case–control study including all women with no prior vaginal delivery undergoing TOLAC during 3/2011–6/2020 with a sonographic estimated fetal weight within one week from delivery. TOLAC success and failure groups were compared. Results: Of 1232 included women, 948 (76.9%) delivered vaginally. The mean fetal SHC was smaller in the TOLAC success group (330 ± 10 vs. 333 ± 11 mm, p < 0.001). In a multivariate regression analysis, predelivery BMI, hypertensive disorders, gestational age at prior CD, SHC and epidural analgesia administration were independently associated with TOLAC success. A ROC analysis of the multivariable model composed of the factors found independently associated with TOLAC success, excluding SHC, yielded an area under curve of 0.659 (95% CI 0.622–0.697) compared with 0.668 (95% CI 0.630–0.705) with SHC included. Conclusion: Smaller SHC is independently associated with TOLAC success among women that did not deliver vaginally before, and has additive clinical value for the prediction of TOLAC success when combined with non-sonographic factors. [ABSTRACT FROM AUTHOR]

Introduction: In this study, it was aimed to evaluate the prenatal, natal and postnatal risk factors that premature babies may encounter and to determine the risk factors affecting this situation in babies with neurodevelopmental retardation. Materials and Methods: In this study, between February 2009 and February 2011, the files of 107 patients (53 girls, 54 boys) which were born before 37 weeks of gestation and continued their outpatient clinic controls in Dr. Behçet Uz Pediatrics Health and Surgery Training and Research Hospital were retrospectively scanned. Neurological examination, cranial MR (magnetic resonance imaging) and Bayley test results of the cases were evaluated. Results: In cases with pathological neurological examination; convulsions (p=0.02), hyperbilirubinemia (p=0.02) and cranial MR pathology (p=0.05) were more common, the increase in head circumference and weight gain in the 4th week were less. With cranial MR pathology; week of gestation (p=0.05), 5th minute APGAR score (p=0.00), gestational diabetes (p=0.01), PDA (patent ductus arteriosus) closure treatment (p=0.02), sepsis (p=0.01), convulsion (p=0.03), anemia (p=0.01), and grade 3 and higher intracranial bleeding (p=0.00) were found to be significantly correlated. When the Bayley test is evaluated; it was determined that those who underwent mechanical ventilation, those who were administered surfactant, those who had convulsions, those with pathological neurological examination, those with EEG (electroencephalography) pathology, and those who remained in the intensive care unit had lower scores (p<0.05). In addition, with the increase in head circumference in the 2nd month, the 6th month psychomotor development index (PDI) score increased in the patients, and the 12th month PDI also increased with the increase in the APGAR score (r>0.5 and p<0.05). Conclusions: In the neurodevelopmental follow-up of premature babies, the presence of gestational diabetes, low weight gain and a reduce in head circumference growth, sepsis, anemia, and a low 5th minute APGAR score were found to be important risk factors, it is important to protect babies from these risk factors for improved neurological development. [ABSTRACT FROM AUTHOR]

Objective: Measuring head circumference is a quick, simple, cheap, noninvasive and reliable procedure for determining underlying brain size and provides information about risk for medical problems. Growth percentages of head vary from one community to another. Methods: We aim to create head circumference growth curves for children aged 0-18 years in Turkish community. Measurements were performed by the same person using a rigid and calibrated tape meter. In addition, the parents were asked to fill out a questionnaire with variables that could affect children's growth. Results: Data analysis has shown that there is no relationship between the children's head circumference and whether there is someone with a large/small head circumference in their families, or the average monthly income of their families and the parent's education level. Only the independent variables child's school performance, birth weight, nutrition, smoking are significantly effective on the HC measures of boys at alpha=0.05 level. For girls, only the independent variables birth weight and nutrition form are significantly important in explaining the variability of HC at the level of alpha=0.05. One gram increase in birth weight causes a 0.001 cm increase in the HC of both genders. In addition, head circumference growth curves were created for both genders to include all children aged 0-18. Conclusions: Our study offers recent and gender-specific head circumference norms. These new values can be used more effectively in child follow-up. [ABSTRACT FROM AUTHOR]

Stature is an essential measurement in anthropometry that resolves individual representation of the body. Forensic determination is the resolution of origin, sex, and natural height. Many previous study has been done on estimation of height using various measurements of teeth and skull. The aim of this study was to estimate stature from head circumference and to derive a linear regression formula between them. The study was conducted in Saveetha Dental College among 70 1st year students (35 males and 35 females). Stature was measured using a stadiometer and head circumference was measured using measuring tape. All the measurements were tabulated and linear regression equation was done using the SPSS software (version 23). For males, Y = 1.85x + 71.12, r = 0.487; for females, Y = 2.07x + 46.24, r = 0.433. By the study, we know that in both genders, head circumference has moderate correlation in estimating stature. From the present research, we conclude that head circumference is a moderately reliable parameter for stature estimation in both genders. [ABSTRACT FROM AUTHOR]

Introduction: The utility of Magnetic Resonance Imaging (MRI) has increased significantly in the assessment of foetal brain development. Foetal biometry is a part of every imaging examination and is needed to confirm that the growth is proceeding normally. Aim: To provide normal MRI reference biometric data of the foetal brain in Indian population. Materials and Methods: This was a retrospective cohort study conducted in the Department of Radiodiagnosis at Sri Ramachandra Hospital, Chennai, Tamil Nadu, India. The data was collected from the MR imaging studies done between January 2013 to December 2020. The present study was carried out on 101 foetuses with gestational age ranging from 20 to 38 gestational weeks with normal brain appearance. Following biometric parameters had been obtained: skull occipitofrontal diameter and Biparietal Diameter (BPD), Brain-Biparietal Diameter (BPD) and fronto-occipital length, Head Circumference (HC), atrial diameter, vermian height, width and area. Descriptive statistics was used to calculate the median value with Interquartile Range (IQR). A p-value of less than 0.05 was considered as significant using Spearman's rank correlation. Results: The skull occipitofrontal diameter (r-value=0.88, p-value <0.001), skull biparietal diameter (r-value=0.92, p-value <0.001), brain biparietal diameter (r-value=0.95, p-value <0.001), brain fronto-occipital length (r=0.94, p-value <0.001), head circumference (r-value=0.92, p-value <0.001), atrial diameter (r-value=0.86, p-value <0.001), Vermian height (r-value=0.86, p-value <0.001), Vermian width (r-value=0.84, p-value <0.001) and Vermian area (r-value=0.88, p-value <0.001) showed positive correlation with gestational age. Mean Head Circumference (HC) and BPD values were almost similar to the standard Indian reference mean values of ultrasound. All biometric parameters were compared with the European references. The values from present study were found to be in the lower range of the European biometric values. Conclusion: Normal biometric MRI data of the foetal brain in an Indian population from 20 to 38 weeks gestational age was presented. A significant correlation was found between gestational age and parameters. MRI BPD and HC values showed a positive correlation with ultrasound BPD and HC values. [ABSTRACT FROM AUTHOR]

Congenital heart disease (CHD) is a common birth defect in the United States. CHD infants are more likely to have smaller head circumference and neurodevelopmental delays; however, the cause is unknown. Altered cerebrovascular hemodynamics may contribute to neurologic abnormalities, such as smaller head circumference, thus we created a novel Cerebrovascular Stability Index (CSI), as a surrogate for cerebral autoregulation. We hypothesized that CHD infants would have an association between CSI and head circumference. We performed a prospective, longitudinal study in CHD infants and healthy controls. We measured CSI and head circumference at 4 time points (newborn, 3, 6, 9 months). We calculated CSI by subtracting the average 2-min sitting from supine cerebral oxygenation (rcSO2) over three consecutive tilts (0–90°), then averaged the change score for each age. Linear regressions quantified the relationship between CSI and head circumference. We performed 177 assessments in total (80 healthy controls, 97 CHD infants). The average head circumference was smaller in CHD infants (39.2 cm) compared to healthy controls (41.6 cm) (p < 0.001) and head circumference increased by 0.27 cm as CSI improved in the sample (p = 0.04) overall when combining all time points. Similarly, head circumference increased by 0.32 cm as CSI improved among CHD infants (p = 0.04). We found CSI significantly associated with head circumference in our sample overall and CHD infants alone, which suggests that impaired CSI may affect brain size in CHD infants. Future studies are needed to better understand the mechanism of interaction between CSI and brain growth. [ABSTRACT FROM AUTHOR]

The associations of early-life head circumference (HC) with child neurodevelopmental and mental health among generally healthy population remain unclear. We aimed to examine the associations of early-life HC trajectories with cognitive development and emotional and behavioral problems in adolescence and to identify the HC growth-sensitive period. We conducted a prospective, community-based birth cohort study in rural western China, and 745 adolescents aged 10-14 years were followed between June and December 2016. We assessed their HC eight times during the first 2 years of life and their adolescent cognitive, emotional, and behavioral outcomes using the Wechsler Intelligence Scale for Children-IV and Youth Self-Report-2001, respectively. We applied group-based trajectory modeling to identify the HC trajectories and conditional growth to derive the HC growth-sensitive periods. We identified five distinct HC trajectories characterized as Start below average-then decrease (7.8% of the sample), Start below average-then increase (6.8%), Start average-then decrease (33%), Consistently average (38%), and Consistently above average (14%). Infants in the trajectory of consistently above average had higher cognitive scores in adolescence compared to those from suboptimal trajectories, with adjusted mean differences ranging from 2.84 to 8.99 points. The conditional gains showed that the HC growth-sensitive period was between 0 and 18 months for child cognition. We found null associations between HC measures and adolescent emotional and behavioral problem scores.Conclusion: Early-life HC trajectories were associated with adolescent cognitive development. HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months, particularly in resource-limited settings.What Is Known: • Postnatal head circumference (HC) has been shown to be associated with cognitive development in infants who were born premature and/or fetal growth restriction, while inconsistent associations were reported among generally healthy populations, especially in low- and middle- income countries, challenging its utility in public health practices.What Is New: • Adolescents in the HC growth trajectory of consistently above average had higher cognitive scores compared to those with other suboptimal trajectories, while null findings were observed for adolescent emotional and behavioral health. • HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months of life, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Background: Head circumference is associated with intelligence and tracks from childhood into adulthood. Methods: We performed a genome-wide association study meta-analysis and follow-up of head circumference in a total of 29,192 participants between 6 and 30 months of age. Results: Seven loci reached genome-wide significance in the combined discovery and replication analysis of which three loci near ARFGEF2, MYCL1, and TOP1, were novel. We observed positive genetic correlations for early-life head circumference with adult intracranial volume, years of schooling, childhood and adult intelligence, but not with adult psychiatric, neurological, or personality-related phenotypes. Conclusions: The results of this study indicate that the biological processes underlying early-life head circumference overlap largely with those of adult head circumference. The associations of early-life head circumference with cognitive outcomes across the life course are partly explained by genetics. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) has been repeatedly associated with enlargements of head circumference in children with ASD. However, it is unclear if these enlargements persist into adulthood. This is the first study to investigate head circumference in a large sample of adults with ASD. Methods: We apply a fully automated magnetic resonance imaging (MRI) based measurement approach to compute head circumference by combining 3D and 2D image processing. Head circumference was compared between male adults with ASD (n = 120) and healthy male controls (n = 136), from the Autism Brain Imaging Data Exchange (ABIDE) database. To explain which brain alterations drive our results, secondary analyses were performed for 10 additional morphological brain metrics. Results: ASD subjects showed an increase in head circumference (p =.0018). In addition, ASD patients had increased ventricular surface area (SA) (p =.0013). Intracranial volume, subarachnoidal cerebrospinal fluid (CSF) volume, and gray matter volume explained 50% of head circumference variance. Using a linear support vector machine, we gained an ASD classification accuracy of 73% (sensitivity 92%, specificity 68%) using head circumference and brain‐morphological metrics as input features. Head circumference, ventricular SA, ventricular CSF volume, and ventricular asymmetry index contributed to 85% of feature weighting relevant for classification. Conclusion: Our results suggest that head circumference increases in males with ASD persist into adulthood. Results may be driven by morphological alterations of ventricular CSF. The presented approach for an automated head circumference measurement allows for the retrospective investigation of large MRI datasets in neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Aim: Can NICU admission of IDM be predicted by anthropometric measurements like birth weight, lenght, head circumference (HC), mid upper arm circumference (MUAC) or triceps skin fold thickness (TSFT). Method: Eighty-six-term IDMs were analyzed prospectively. MUAC, HC and TSFT were measured within 48 hours of life. Prenatal-natal-postnatal problems; NICU admission; maternal characteristics, HbA1c were recorded. Results: Mean birth weight, gestational age were 3453.3±582.4g and 38.0±0.97weeks. 63.9% of IDMs was admitted to NICU. 56.3% hospitalized due respiratory problems; 32,7 % required endotracheal intubation. Mean MUAC, TSFT, HC and MUAC/HC ratio were 11.2±1.1 cm, 7.1±2.2 mm, 35.0±1.8 cm and 0.32±0.03 cm respectively for all. Although there was no significant relation between NICU admission and MUAC (p=0.071), TSFT and MUAC/HC were significantly higher in babies admitted to NICU (p=0.006 for TSFT, p<0.001 for MUAC/HC). HC was significantly low in babies followed in NICU (P<0.001). With increment of TSFT, MUAC/HC and HbA1c, NICU admission increases positively, but HC affects NICU admission negatively (OR for TSFT:1.6, OR for MUAC/HC: 2.1, OR for HbA1c: OR for HC:0,3). Mechanic ventilation requirement is affected positively by TSFT (p=0.008, OR:1.5) and affected negatively by HC (p=0.004, OR:0.6). Conclusion: This preliminary study showed; TSFT, HC and MUAC/HC ratio are helpful criterias to predict NICU admission risk for IDMs and might be helpful for risk assesment in limited settings. [ABSTRACT FROM AUTHOR]

Background: Achondroplasia is the most common genetic skeletal disorder causing disproportionate short stature/dwarfism. Common additional features include spinal stenosis, midface retrusion, macrocephaly and a generalized spondylometaphyseal dysplasia which manifest as spinal cord compression, sleep disordered breathing, delayed motor skill acquisition and genu varus with musculoskeletal pain. To better understand the interactions and health outcomes of these potential complications, we embarked on a multi-center, natural history study entitled CLARITY (achondroplasia natural history study). One of the CLARITY objectives was to develop growth curves (length/height, weight, head circumference, weight-for-height) and corresponding reference tables of mean and standard deviations at 1 month increments from birth through 18 years for clinical use and research for achondroplasia patients.Methods: All available retrospective anthropometry data including length/height, weight and head circumference from achondroplasia patients were collected at 4 US skeletal dysplasia centers (Johns Hopkins University, AI DuPont Hospital for Children, McGovern Medical School University of Texas Health, University of Wisconsin School of Medicine and Public Health). Weight-for-age values beyond 3 SD above the mean were excluded from the weight-for-height and weight-for-age curves to create a stricter tool for weight assessment in this population.Results: Over 37,000 length/height, weight and head circumference measures from 1374 patients with achondroplasia from birth through 75 years of age were compiled in a REDCap database. Stature and weight data from birth through 18 years of age and head circumference from birth through 5 years of age were utilized to construct new length/height-for-age, weight-for-age, head circumference-for-age and weight-for-height curves.Conclusion: Achondroplasia-specific growth curves are essential for clinical care of growing infants and children with this condition. In an effort to provide prescriptive, rather than purely descriptive, references for weight in this population, extreme weight values were omitted from the weight-for-age and weight-for-height curves. This well-phenotyped cohort may be studied with other global achondroplasia populations (e.g. Europe, Argentina, Australia, Japan) to gain further insight into environmental or ethnic influences on growth. [ABSTRACT FROM AUTHOR]

Objective  We sought to determine if variation in head circumference (HC) within the range of normal (5th–10th and 90th–95th percentile) is associated with poor neurodevelopmental outcomes (NDO), which defined as mild or moderate delay by Bayley II psychometrics (BSID-II). Study Design  This is a secondary analysis of a randomized controlled trial assessing the benefits of magnesium for the prevention of cerebral palsy. Fetuses with a normal HC at birth defined as within 5th to 95th percentile were included. NDO were assessed at age 2 with BSID-II. Moderate delay was defined as a score <70 and mild delay as <85. HC was classified as small normal (5th–10th percentile), normal (10th–90th percentile), and large normal (90th–95th percentile). Logistic regression models adjusted for confounding. Linear regression models estimated the impact for every 1 cm of change in HC. Results  Of 1,236 included infants, 111 (8%) had small normal HC; 1,058 (85%) had normal HC; and 67 (5%) had large normal HC. Baseline characteristics were similar between groups. There was no association with changes in HC within the range of normal and developmental indices. When considered as a continuous variable, every 1 cm increase in HC was also not associated with a significant change in developmental indices. Conclusion  Within the normal range (5th–95th percentile), changes in HC did not correlate with changes in NDO at 2 years as measured by Bayley II scales. Key Points It is unknown if variations in normal HC are associated with poor neurodevelopmental outcomes. Alterations in HC within the range of normal (5th–95th percentile) are not associated with adverse NDO. When considered as a continuous variable, a 1 cm increase in HC is not associated with adverse NDO. Changes in HC within the range of normal do not appear to be a pathologic change altering NDO. [ABSTRACT FROM AUTHOR]

Introduction: Cephalopelvic disproportion (CPD) is one of the most common obstetric complications. Since CPD is the disproportion between the fetal head and maternal bony pelvis, evaluation of the head circumference (HC) relative to the maternal bony pelvis may be a useful adjunct to pre-labor CPD evaluation. The aim of the present study was a proof-of-concept evaluation of the ratio between HC and pelvic circumference (PC) as a predictor of CPD.Methods: Of 11,822 deliveries, 104 cases that underwent an abdominopelvic CT for any medical indication and who underwent normal vaginal deliveries (NVDs) (n = 84) or cesarean deliveries (CD) due to CPD (n = 20) were included retrospectively. Maternal pelvis dimensions were reconstructed and neonatal HC, as a proxy for fetal HC, was measured. The correlation between cases of CPD and cephalopelvic circumference index (CPCI), which represents the ratio between the HC and PC in percentage (HC/PC × 100), was evaluated.Results: The mid-pelvis CPCI (MP-CPCI) was larger in CD groups as compared to the NVD group: 103 ± 11 versus 97 ± 8%, respectively (p = 0.0003). In logistic regression analysis, the MP-CPCI was found to be independently associated with CD due to CPD: each 1% increase in MP-CPCI increased the likelihood of CD for CPD by 11% (adjusted odds ratio [aOR] 1.11, 95% CI, 1.03-1.19, p = 0.004). The aOR for CD due to CPD increased incrementally as the MP-CPCI increased, from 3.56 (95% CI, 1.01-12.6) at MP-CPCI of 100 to 5.6 (95% CI, 1.63-19.45) at 105, 21.44 (95% CI, 3.05-150.84) at 110, and 28.88 (95% CI, 2.3-362.27) at MP-CPCI of 115.Conclusions: The MP-CPCI, representing the relative dimensions of the fetal HC and maternal PC, is a simple tool that can potentially distinguish between parturients at lower and higher risk of CPD. Prospective randomized studies are required to evaluate the feasibility of prenatal pelvimetry and MP-CPCI to predict the risk of CPD during labor. [ABSTRACT FROM AUTHOR]