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Summary The integration of the growth of the brain and the cranial base suggests that each system may influence the other, notably during the first three years of life, although this influence has never been proven to be exclusive. The aim of our work was to analyse the dynamics of normal growth on the one hand, and the development and ontogenetic allometry of the cranial base in the infant on the other hand. Material and method A total of 32 infants (17 males/15 femeles) having been included in the unexpected infant death french protocol were analyzed. Three-dimensional reconstructions of the cranial base were performed from CT scans. The technique combined manual segmentation of regions of interest, contour extraction and surface reconstruction. Nineteen landmarks were positioned on each of the bone surfaces. Results No correlation was observed between sex assigned at birth and shape, weight, crown-heel length, or head circumference. Principal component analysis showed that 85.5% of the variance observed on the first component was secondary to growth. After Procrustes superimposition, 25% of the shape variance observed was explained by the first principal component. It showed anteroposterior lengthening of the cranial base. In addition, the height, width and length of the posterior fossa increased and the relative position of the basion was displaced inferiorly and anteriorly with flexion of the sphenoid angle. Negative allometry was also observed. Conclusion Our study, carried out in a rigorously selected population of infants, presents a fundamental approach to ontogeny through study of shape, growth and ontogenetic allometry.

To identify risk factors for increasing severity of OASI and evaluate its possible correlation with two known risk factors-birth weight (BW) and neonatal head circumference (HC).We performed a retrospective cohort study at a university affiliated hospital between 2003 and 2019. We compared five groups of patients - according to presence and degree of perineal laceration - 3a, 3b, 3c and 4 and patients without OASI. Additionally, four parameters were defined to assess their relation to the severity of OASI: (1) BW ≥ 90th and HC 90th percentiles; (2) BW 90th and HC ≥ 90th percentile; (3) BW and HC ≥ 90th percentile and (4) BW and HC 90th percentiles.During the study period, 150,221 deliveries were evaluated. Parturients were allocated according to OASI severity - 455 patients had a 3rd (3a, 3b or 3c) or 4th degree perineal tear, while 110,966 patients had no OASI. Allocation to subgroups according to offspring anthropomorphic measures showed that as fetal size parameters increased, the rate of more severe tears increased, particularly in women delivering neonates with HC ≥ 90th percentile. Multinomial regression analysis was performed for each 3rd degree OASI subgroup. This analysis demonstrated the odds for OASI gradually increase with tear severity for BW ≥ 90th percentile and the combined BW and HC ≥ 90th percentile parameters, as compared with neonates with HC and BW 90th percentile.Birth weight and head circumference above the 90th percentile are correlated with increased degree of OASI severity.

To determine the characteristics of adults who survived early life malnutrition (ELM) and the possible associated factors. The setting is an impoverished community in Kenya. The coastal region of Kenya has a high prevalence of acute protein-energy-malnutrition and stunting.Observational cross-sectional survey where 872 skeletally mature adults of African origin, were surveyed in a period of three months. A discrimination tool to detect ELM survivors was created. Personal, historical and family data were collected in a semi-structured questionnaire. Various observations and body measurements were done. The subjects were grouped into two, those with ELM (Group1), and those without (Group2).Group1 had 242 participants, 49.8% males, mean age of 49.1 ± 8.7 years. Group2 had 630 participants, 48.3% males, mean age 41.0 ± 9.7 years. The phenotypic characteristics included height, BMI, and head circumference (P 0.05). Developmental characteristics were duration of schooling, occupation and income (P 0.001). Factors associated with malnutrition were County of origin, parental education, parental occupation, and family size (P 0.001).There are discernible phenotypic and developmental characteristics associated with adult survivors of ELM. The predisposing factors for ELM are location of birth, parental education and occupation, and family size.

Objective Compare the effect of Moringa oleifera (MO) leaf extract and iron tablets on pregnant women on low birth weight. Methods This study used a Randomized Double-Blind design controlled by using a sample of non-anemic pregnant women. Birth weight was measured using a digital scale electrically after delivery. Analysis of data using two independent samples t-test. Results Overall, there were no significant different between intervention and control group in terms of birth weight (3104.57 ± 52 vs. 3022.29 ± 53 g), birth length (48.06 ± 2.4 vs. 48.68 ± 2.6 cm), and head circumference (33.72 ± 1.50 vs. 33.55 ± 1.47 cm). The number of low birth weight infants in the intervention group of 8.6% and 11.4% of control. There is no difference in birth weight between the intervention with the control group (p = 0.365). Conclusion M. oleifera (MO) leaf extract supplement has similar effect to iron folate supplement in terms of low birth weight incidence. It is recommended for the government to use MO supplement, as local source supplement, replacing iron-folic supplement in improving pregnancy outcomes. A further study is necessary to see the effect of MO supplement to other pregnancy outcomes, including maternal and child mortality.

To test the equivalence of two fetal weight estimation formulas generated by Hadlock, a formula that includes head circumference parameter (H1), and another (H2) which excludes this parameter. A secondary aim was to identify the patients in which H2 formula is less reliable to use.This retrospective cohort study included a total of 1220 sonographic fetal weight estimations performed within seven days of delivery and recorded at a single medical center from January 2014 to December 2016. Estimated fetal weight was calculated using H1 and H2 formulas. Their accuracies were compared using percentage error, the proportion of weight estimations falling within ±15% error interval and by Bland-Altman analysis. Multivariate regression was performed to evaluate factors affecting weight estimation by H2 formula.The mean birth weight was 3288.92 ± 641.27gr. The H2 formula presented with statistically significant higher value of systemic mean percent error comparing to H1 (3.19% vs. 1.87%, p 0.001 respectively). H2 formula had a lower accuracy compared to H1 in predicting fetal weight within ±15% of birth weight (90.49% vs. 93.44%, p 0.01 respectively). Using Bland-Altman analysis, the 95% limits of agreement between both formulas were (-142.03) to 231.79gr with a mean of 44.88gr. Factors found to influence significantly on H2 formula were long femur length (OR 1.144, p 0.0001) and low maternal age (OR 0.947, p 0.01).H1formula was more accurate than H2 formula in predicting fetal weight at term. However, the accuracy difference was found to be small. Therefore, if ultrasonographic evaluation of HC is technically difficult, Hadlock formula that excludes head circumference can be used with confidence. Caution should be paid with higher values of femur length and lower maternal age.

OBJECTIVES: To estimate the association between fetal congenital heart defects (CHDs) and measures of brain size throughout pregnancy, from the end of the first trimester to birth.STUDY DESIGN: The cohort consisted of all fetuses scanned in Western Denmark in 2012 and 2013. Anthropometric measures in fetuses with isolated CHDs diagnosed within 12 months after birth were compared with those in the fetuses without CHDs. Z-scores standardized to gestational age were calculated for first trimester biparietal diameter, second trimester head circumference, fetal weight, birthweight, head circumference, and placental weight.RESULTS: We obtained data from 63 349 pregnancies and identified 295 fetuses with isolated CHDs (major n = 145; minor n = 150). The first trimester mean biparietal diameter Z-scores were not different between those with and those without CHDs. The head circumference mean Z-score difference was -0.13 (95% CI, -0.24 to -0.01; P = .03) in the second trimester and -0.22 (95% CI, -0.35 to -0.09; P < .001) at birth. Fetuses with univentricular physiology or tetralogy of Fallot showed the most pronounced compromise in cerebral size.CONCLUSIONS: Our results suggest that the brain alterations inducing an increased risk of impaired neurodevelopment in children with CHDs begin during pregnancy. Although fetuses with univentricular physiology or tetralogy of Fallot exhibited the most pronounced compromise in cerebral size, we recommend neurodevelopmental follow-up for all children with CHDs.

Objectives Scholastic achievement (SA) is a multifactorial problem that depends on factors related to the child, the child's family, and the educational system. The aim of this study was to quantify the relative impact of significant variables at the beginning of high school during 2010 (first grade of high school [1 HSG]) on 2013 university selection test (Prueba de Seleccion Universitaria [PSU]) outcomes, both in language scholastic achievement (LSA) and mathematics scholastic achievement (MSA), when students graduated from high school (4 HSG). This was done at the time of university admission with a multicausal approach. The purpose was to confirm the hypothesis that the level of educational establishment SA, intellectual ability, sex, parental schooling levels, and head circumference for age Z-score at the onset of high school are the most relevant parameters associated with 2013 PSU outcomes, both in LSA and MSA. Methods A representative, proportional, and stratified sample of 671 children of both sexes who enrolled in 1 HSG in 2010 (mean age: 14.8 ± 0.6 y) participated in the study. Nutritional, intellectual, brain developmental, cardiovascular risk, socio-to-economic, demographic, and educational variables were quantitated. SA was assessed at 4 HSG with the 2013 PSU tests. Data were analyzed with SAS software. Results Educational establishment SA, intellectual ability, maternal schooling, and age Z-score were the most relevant parameters to explain LSA (R2 = 0.493; P Conclusions These findings confirm the hypothesis and can be useful to support nutritional, health, and educational planning.

Backgrounds Congenital heart disease (CHD) can lead to under vascularization of placenta, which can affect fetal development and subsequent neurological outcome. No data are currently available regarding neurodevelopmental outcome of children born to mothers with CHD. Methods Characteristics of pregnancy, birth and neonatal period, items of neurodevelopment during infancy recorded in health book, need for speech therapist, physiotherapist, school helper and grade repetition were retrospectively collected in children under 10 years old born to CHD mothers followed up in 5 French congenital heart disease centres, and compared to a control population (children and brotherhood from mother consulting in 2 paediatric traumatology emergency rooms). Children under 7 years old of both groups were prospectively screened for neurodevelopmental trouble using the neurodevelopmental test developed by the “Haute Autorite de Sante” (HAS). Results One hundred and nineteen children from 83 CHD mothers and 122 children from 118 control mothers were included. Children from CHD mothers were born earlier (37.9 ± 2.6 vs. 39.3 ± 1.5 WA) and with a higher rate of prematurity (17.6 vs. 4.9%). They displayed lower birth weights (2910 ± 650 vs. 3370 ± 500 g), lower APGAR scores at 1 minute (8.6 ± 2.3 vs. 9.3 ± 1.5) and a smaller head circumference at 9 months (44.7 ± 1.4 vs. 45.3 ± 1.4 cm). There was no difference in the age of walking and head circumference at 24 months, as well as grade repetitions and need for speech therapist, physiotherapist, or school helper. The HAS neurodevelopmental test suspected trouble in 5.9% of children from CHD mothers and 11.5% of control children (NS). Conclusion Despite increased prematurity and worse APGAR score, children from mothers with CHD appear not to show symptoms of neurodevelopment impairment in our study.

An emerging body of evidence has associated exposure to traffic-related air pollution (TRAP) during pregnancy with birth outcomes. However, the evidence on the association of TRAP exposure and neonatal anthropometric measurements (NAPM) in low and middle-income countries is very scarce yet. Therefore, we investigate the association of prenatal exposure to indicators of traffic and ambient particulate matter (PM) with NAPM. This cross-sectional study was based on hospital medical records of 4053 mother-neonate pairs between May 16, 2016, and December 5, 2018. PMs were estimated at residential addresses based on validated spatiotemporal models. Moreover, total street length in 100, 300 and 500m buffers around the home, residential distance to the ring road, major roads, heavy-traffic lights, gas station, motorway junction, bank, square, bus terminal, public parking and industrial land-use were calculated as indicators of traffic. The head circumference (HC), birth weight (BW) and birth length (BL) of neonates were collected as NAPM. Multivariate regression models were applied to evaluate the relationship between PMs and indicators of traffic with NAPM, controlled for relevant covariates. The median (IQR) of BW, BL, and HC of newborns were 3250 (592) gr, 51.0 (3.5) cm, 35 (2) cm, respectively. The adjusted models revealed that higher exposure to PM2.5 and PM10 was significantly related with lower BW and BL. Similar results were observed for total street length in a 100 m buffer around maternal home with BW and BL. Moreover, higher distance to heavy traffic lights was significantly associated with higher BW and BL. An IQR increase in PM10 was significantly related to lower HC (95% CI: 0.11, −0.01, P-value = 0.03). An increase in distance from residential address to heavy traffic lights, ring roads, bus terminal, and transportation land-use was associated with higher HC. Overall, our findings suggested that higher prenatal exposure to TRAP was related with lower BW, BL and HC.

Resumen: Introducción: La restricción posnatal del crecimiento es considerada un problema universal en recién nacidos extremadamente prematuros (RNEP), generando gran preocupación debido a la posible relación entre nutrición, crecimiento posnatal subóptimo y alteraciones del neurodesarrollo. Objetivos: Describir la evolución de la ganancia posnatal de peso en RNEP y conocer los cambios en la longitud y el perímetro craneal (PC) al alta hospitalaria en los supervivientes. Pacientes y métodos: Se estudió a 4.520 RNEP de raza blanca, de gestaciones únicas y sin malformaciones, nacidos en los centros participantes en la red española SEN1500 (2002-2011). El peso se registró al nacimiento, 28 días, 36 semanas de edad posmenstrual y al alta hospitalaria. La longitud y el PC se estudiaron al nacimiento y al alta. Resultados: La velocidad de ganancia ponderal fue de 8,0 g/kg/día (nacimiento-28 días); 14,3 g/kg/día (28 días-36 semanas), y 11,7 g/kg/día (36 semanas-alta hospitalaria). Al alta, la restricción posnatal del crecimiento fue mayor para la longitud (z-score entre −1,78 y −2,42, en función de la edad gestacional), seguida del peso (−1,67 a −1,79) y, finalmente, el PC (−0,69 a −0,81). Conclusiones: Los RNEP presentan una velocidad de ganancia ponderal lenta en las primeras semanas tras el nacimiento y una restricción posnatal del crecimiento que afecta en mayor grado a la longitud y al peso. Además del peso, un control estrecho del crecimiento longitudinal y del PC es fundamental para la valoración nutricional y la detección de pacientes de riesgo respecto al crecimiento y el neurodesarrollo tras el alta hospitalaria. Abstract: Introduction: Postnatal growth restriction is considered a universal problem in extremely premature infants (EPI), and causes great concern due to the possible relationship between nutrition, sub-optimal postnatal growth, and neurodevelopment delay. Objectives: To describe the weight gain in EPI and to determine the changes in the length and head circumference (HC) at hospital discharge in survivors. Patients and methods: The study included 4,520 Caucasian EPI from single pregnancies and without severe malformations, born in the centres participating in the Spanish SEN1500 network (2002-2011). The weight was recorded at birth, 28 days, 36 weeks post-menstrual age (PMA), and at discharge. The length and HC were measured at birth and at discharge. Results: The rate of weight gain (exponential method) was 8.0 g/kg/d (birth - 28 days); 14.3 g/kg/d (28 days - 36 weeks); and 11.7 g/kg/d (36 weeks - discharge). At discharge, postnatal growth restriction was greater for length (z-score between −1.78 and −2.42, depending on GA), followed by weight (−1.67 to −1.79), and HC (−0.69 to −0.81). Conclusions: Weight gain in the first weeks after birth is slow in EPI, and they exhibit an almost universal postnatal growth restriction that involves mainly length and weight. In addition to weight, a close control of longitudinal growth and HC are essential for nutritional assessment and detection of patients at risk for poor growth and neurodevelopment after hospital discharge.

Background The present study presents results of head circumference (HC) measurements in a group of children being part of a larger group of children referred for neuropsychiatric assessment to a neuropsychiatric assessment team in Sweden. Methods Of the 126 children included in the present study HC was possible to measure in 114 individuals. However, two of these children were not diagnosed since they did not conclude the study, leaving 112 children for further assessment. In addition, birth data was recovered either from the digital birth sheet used in Sweden for the registration of birth data, or in a few cases from the Child Care Centers or medical journals if the child had been admitted to hospital care after birth. Results Of the 112 individuals, only one individual, a boy, diagnosed with ICD-10 Autism, had a HC above the 97.5th percentile at birth. At the physical assessment included in the study one individual, a boy (not the same boy as mentioned above) was found to have a HC above the 97.5th percentile. Hence, 1.2 % of the boys in this study with an ICD-10 ASD diagnosis were macrocephalic. In contrast, 6.7 % of the boys, and 8% of the girls, who received an ICD-10 ASD diagnosis had a HC below the 2.5th percentile and were considered microcephalic at the assessment. Conclusions The results from this study could not confirm previous research arguing macrocephaly to be considerably more common in ASD than in the general population. However, in contrast, the results from this study indicated that microcephaly could be more common in children with ICD-10 ASD, for both sexes, than in the general population. Since none of the children had been microcephalic at birth the results indicate a relative decrease in HC over time in these individuals.

Background The monitoring of head circumference (HC) is essential to early detect any conditions affecting its growth in early childhood. A positive secular trend and regional specificities in HC suggested the need to provide updated national HC reference growth charts. Methods We extracted all growth data collected from 42 primary-care physicians from across the French metropolitan territory who used the same electronic medical-records software. We selected HC measurements up to age five years for all children who were born after 1990 with birth weight > 2500 g. We derived new HC growth charts by using Generalized Additive Models for Location, Scale and Shape, then externally validated them until 30 months of age by comparison with the national population-based Etude Longitudinale Francaise depuis l'Enfance (ELFE) birth cohort and compared them to previous French and WHO growth charts. Findings With 973,869 HC measurements from 157,762 children, new calibrated HC growth charts from birth to age five years were generated. The new HC growth charts showed good external fit by comparison with the ELFE birth cohort. As compared with the new HC growth charts, the previous French and WHO growth charts mean HC z-scores were, respectively, -0.4 and -0.6 SD for girls and -0.2 and -0.6 SD for boys. Interpretation We produced and validated national calibrated HC growth charts by using a novel big-data approach applied to data routinely collected in clinical practice. Comparison with previous French and WHO growth charts confirmed a positive secular trend since the 1960s and regional specificities. Funding The French Ministry of Health; Laboratoires Guigoz—General Pediatrics section of the French Society of Pediatrics—Paediatric Epidemiological Research Group; the French Association of Ambulatory Pediatrics; and educational grant from the Regional Health Agency of Ile-de-France.

Resume La decouverte d’un perimetre cephalique (PC) inferieur au 3epercentile (p), au meme titre que le femur court ou l’hyperclarte de nuque a caryotype normal, demeure l’une des situations les plus difficiles pour le praticien en diagnostic prenatal. La microcephalie constitue une porte d’entree d’eventuelles pathologies cerebrales diverses; cependant l’objectif principal est d’identifier les situations graves accessibles en periode prenatale. Une mesure standardisee du PC, l’utilisation d’outils et de courbes de references adaptes, un suivi longitudinal des biometries cephaliques dans les situations a risques, et une analyse systematisee du systeme nerveux central peuvent permettre d’augmenter les performances diagnostiques de l’echographie souvent decevantes pour la microcephalie. La distinction precoce entre microcephalie associee ou isolee permet d’orienter rapidement la conduite a tenir et le conseil prenatal. L’IRM fœtale et la consultation de genetique sont fondamentaux dans ce contexte, ils permettent de preciser, au mieux, le diagnostic etiologique et d’apporter une aide au neuropediatre dans l’etablissement d’un pronostic souvent incertain. La recente augmentation des cas de microcephalie concomitante a l’epidemie du virus ZIKA est un argument supplementaire pour ameliorer nos pratiques et l’apprehension au quotidien des PC

We consider the effects of major prenatal economic shocks experienced by mothers on two indicators of newborn-infant health, birth weight and head circumference, using detailed microdata from the UK ALSPAC survey. Controlling for physiological and socioeconomic factors, an economic shock in the first 18 weeks of gestation lowers birth weight by 40–70 g and head circumference by 2–3 mm. We find evidence of transmission via poorer maternal health due to absolute material deprivation and tobacco and alcohol consumption, but not for the endocrinological effects of increased psychosocial anxiety. The fragile-male hypothesis holds for birth weight but not for head circumference, as predicted by recent theories on gender differences in prenatal development.

Cabbage Brassica oleracea var. capitata L. is one of major winter leafy vegetable which belong to cruciferae family. The local seedlings of 30 days’ cabbage were implanted in 100 m2 land in the Abu Ghraib region, Baghdad, at the 1st of October 2019 and harvested after 75 days, as one agriculture season in Iraq. The plants divided into 6 groups, each includes 45 plants. One of the six groups do not receive any type of fertilizers, as control, while the last 5 groups received different types of nanofertilizers every 21 days. CeO2 prepared by laser ablation and commercial iron and zinc nanoparticles were characterized by field emission scanning electron microscope (FE-SEM), x-ray diffraction (XRD) and energy dispersive x–ray (EXD). The three metal nanoparticles were used as microelements to enhance NPK nanofertilizer. Cabbages that fertilized with nanofertilizers revealed higher circumferences (not less 49.42 cm) when compared with control (28.17 cm). High average of head circumference (56.22 cm) was observed when plant fertilized with NPK + Fe nano fertilizer. On the other hand, cabbages that did not receive any nano fertilizers, as control, show height head of 10.67 cm, while the height head average of 16.67 cm was observed when plant fertilized with NPK + Fe nano fertilizer. Moreover, the higher average of cabbage head weight increased three times more than than control to reach 1.88 Kg/plant when the cabbage fertilized with NPK + CeO2 NPs within 75 days. Furthermore, the higher chlorophyll content of 131.22 mg / 100 g plant leaves was observed in cabbage that fertilized with NPK + CeO2 NPs. Significant differences were obtained between the higher values and others.

Background and Objectives Measuring head-circumference (HC) length from ultrasound (US) images is a crucial clinical task to assess fetus growth. To lower intra- and inter-operator variability in HC length measuring, several computer-assisted solutions have been proposed in the years. Recently, a large number of deep-learning approaches is addressing the problem of HC delineation through the segmentation of the whole fetal head via convolutional neural networks (CNNs). Since the task is a edge-delineation problem, we propose a different strategy based on regression CNNs. Methods The proposed framework consists of a region-proposal CNN for head localization and centering, and a regression CNN for accurately delineate the HC. The first CNN is trained exploiting transfer learning, while we propose a training strategy for the regression CNN based on distance fields. Results The framework was tested on the HC18 Challenge dataset, which consists of 999 training and 335 testing images. A mean absolute difference of 1.90 ( ± 1.76) mm and a Dice similarity coefficient of 97.75 ( ± 1.32) % were achieved, overcoming approaches in the literature. Conclusions The experimental results showed the effectiveness of the proposed framework, proving its potential in supporting clinicians during the clinical practice.

Measurement of the fetal brain can be achieved by different modalities, we aimed to assess the agreement between these methods and the head circumference at birth.A retrospective study conducted between 2011-2018 at a tertiary referral medical center. Sonographic head circumference (HC), 2D MRI bi-parietal diameter (BPD) and occipito-frontal diameter (OFD), 3D MRI supra-tentorial volume (STV), and head circumference (HC) at birth were measured and converted into centiles according to gestational age. Spearman's rank correlation coefficient was used to assess the correlation between the modalities.A total of 88 fetuses were included. Mean gestational age at the time of fetal US and brain MRI acquisition were 34.4 ± 2.8 and 34.6 ± 2.6 weeks, respectively. A correlation was found between prenatal sonographic HC and the 3D MRI STV centiles (Rs = 0.859, p 0.001), the BPD in 2D MRI (Rs = 0.813, p 0.001), and the OFD in 2D MRI (Rs = 0.840, p 0.001). Sonographic HC, OFD on 2D MRI, and STV on 3D MRI were all found to be correlated with the HC at birth (Rs = 0.865, p 0.001; Rs 0.816, p 0.001; Rs = 0.825, p 0.001, respectively).There is a statistically significant agreement among the different prenatal clinically used modalities for measuring fetal brain and the head circumference at birth, however, this correlation is not perfect. Further study is needed to investigate the long-term prognosis of these fetuses.

Heavy metals such as lead (Pb), mercury (Hg), and cadmium (Cd) were detected in the islands of Yangtze River estuary and Hangzhou bay and their exposure caused potential health risk for the residents. To assess the exposure levels of Pb, Hg, and Cd, the umbilical cord serum samples were collected from 103 mother-newborn pairs as the noninvasive specimens. The association of the concentration of Pb, Hg, and Cd with the birth outcomes was evaluated. Pb, Hg, and Cd had high exposure levels with the median concentrations at 76.20 μg L(-1) [interquartile range (IQR): 44.71, 115.80], 21.94 μg L(-1) (IQR: 15.10, 27.64), and 6.36 μg L(-1) (IQR: 3.63, 13.34), respectively. A unit increase in the Pb umbilical cord serum concentration (μg L(-1)) was significantly associated with a 0.29 cm (95% CI: -0.50, -0.09) decrease in birth height and a 0.22 cm (95%CI: -0.44, 0.00) decrease in head circumference. The middle tertile Pb and Hg exposure levels were found significantly negative effects on birth outcomes compared with low tertile exposure levels. Exposure to Cd showed no apparent effect on birth outcomes. Our results suggested that Pb and Hg exposure has potential adverse effects on birth outcomes in Chinese fish consumers from Yangtze River outlet and Hangzhou bay estuary regions.

Congenital MPHD is a rare condition caused by mutations in pituitary transcription factors genes: PROP1, POU1F1 (PIT1), HESX1, LHX3, LHX4.We evaluated in a retrospective study the effects on growth and development in 29 patients with congenital MPHD (cMPHD), during hGH replacement therapy alone and combined with sex hormones. Twenty nine patients with cMPHD were included and diagnosed, treated and followed in our clinic from diagnosis to adult age. Measurements on growth and development were taken by the same medical team.Mean birth weight of 21/29 neonates was 3126 ± 536 g. Mean birth length of 7/29 neonates was 48.7 ± 2 cm. Neuromotor development was normal or slightly delayed. Mean age at referral was 9.5 ± 7 years (m), 6.7 ± 3.5 years (f) (p=0.17). Height (SDS) before treatment was -2.8 ± 1.0 (m), -2.8 ± 1.0 (f) (p=0.99). Mean age at initiation of hGH treatment was 9.9 ± 6.7 years (m), 10.3 ± 4.2 years (f) (p=0.85). Mean age at initiation of sex hormone treatment was 17.0 ± 3.5 years (m), 17.1 ± 2.3 years (f) (p=0.88). Penile and testicular sizes were below normal before and after treatment. Head circumference (SD) was -1.9 ± 0.9 before and -0.6 ± 1.8 at end of treatment (p0.001). Adult height (SDS) reached -1.1 ± 0.6 (p0.001) for both males and females.Despite the multiple pituitary hormone deficiencies including hGH, children with congenital MPHD present with a better auxological development than children with congenital IGHD or congenital IGF-1 deficiency. These findings may be due to irregular and incomplete hormone deficiencies increasing with progressive age and late initiation of puberty.

Very-low-birthweight infants (VLBWIs) are at high risk for suboptimal bone mineral density (BMD) and bone mineral content (BMC). Small-for-gestational-age (SGA) status also causes reduced bone mineralization in full-term infants. However, the impact of intrauterine and postnatal extrauterine growth on BMD and BMC in VLBWIs is inconclusive.We retrospectively investigated n=68 VLBWIs, comprising 45 appropriate-for-gestational-age (AGA) and 23 SGA infants who underwent lumbar spine dual-energy X-ray absorptiometry at term-equivalent age.BMD and BMC did not differ between AGA and SGA VLBWIs. Subgroup analyses of infants with birthweight1000 g vs 1000-1500 g, and GA27 weeks vs ≥ 27 weeks also showed no differences in BMD and BMC between AGA and SGA infants. In contrast, infants with extrauterine growth restriction (EUGR) showed significantly lower values than those without (BMD: 0.124 ± 0.023 vs 0.141 ± 0.032 g/cm(2), P=0.02; BMC: 0.80 ± 0.26 vs 0.94 ± 0.23 g, P=0.04). There were no differences between AGA and SGA infants with EUGR. However, in the AGA cohort, infants with EUGR showed significantly lower values than those without (BMD: 0.121 ± 0.022; 0.141 ± 0.03 g/cm(2), P=0.02; BMC: 0.73 ± 0.23 vs 0.94 ± 0.23 g, P=0.005). Multiple regression analyses showed GA, weight and head circumference at birth, and weight percentile at term correlated with term BMD. Conversely, only weight percentile at term significantly correlated with term BMC.EUGR, rather than IUGR, is a risk factor for reduced BMD and BMC in the neonatal period in VLBWIs.

The objective of this study is to evaluate the influence of placental concentrations of some organochlorine pesticides on newborn's anthropometric measurements (height, weight, head circumference & ponderal index). For this study, we have collected 90 placental tissue samples for the measurement of Dichlorodiphenyltrichloroethane (DDT) & Hexachlocyclohexane (HCH) by Gas Chromatography equipped with Electron Capture Detector (GC-ECD). Regression analysis were performed between outcome variables such as birth weight, birth height, head circumference, ponderal index and independent variable i.e., organochlorine pesticide concentrations. In case of birth weight, there was a substantial decrease of 5.81, 1.94, 4.71, and 2.64 g for 1 ppb (μg/L) increase in placental α-HCH, β-HCH, γ-HCH, and total HCH concentrations respectively. Significant decrease of 2.02 and 0.43 kg/m3 in ponderal index was found with 1 μg/L increase of total-HCH and total DDT concentrations in placenta. The results of this study support an association between environmental exposure to organochlorine pesticides and anthropometric development of the fetus leading to a significant reduction in its birth weight and ponderal index, slight and non-significant reduction in birth height and head circumference. Efforts should be made to reduce exposure of women of reproductive age in relation to long-term impact on health.

Macrocephaly and brain overgrowth have been associated with autism spectrum disorder. We performed a systematic review and meta-analysis to provide an overall estimate of effect size and statistical significance for both head circumference and total brain volume in autism. Our literature search strategy identified 261 and 391 records, respectively; 27 studies defining percentages of macrocephalic patients and 44 structural brain imaging studies providing total brain volumes for patients and controls were included in our meta-analyses. Head circumference was significantly larger in autistic compared to control individuals, with 822/5225 (15.7%) autistic individuals displaying macrocephaly. Structural brain imaging studies measuring brain volume estimated effect size. The effect size is higher in low functioning autistics compared to high functioning and ASD individuals. Brain overgrowth was recorded in 142/1558 (9.1%) autistic patients. Finally, we found a significant interaction between age and total brain volume, resulting in larger head circumference and brain size during early childhood. Our results provide conclusive effect sizes and prevalence rates for macrocephaly and brain overgrowth in autism, confirm the variation of abnormal brain growth with age, and support the inclusion of this endophenotype in multi-biomarker diagnostic panels for clinical use.

Introduction: Our aim was to investigate the correlations between patterns of head growth and intellectual disability among distinct aetiological presentations of microcephaly. Patients and methods: 3269 head circumference (HC) charts of patients from a tertiary neuropaediatric unit were reviewed and 136 microcephalic participants selected. Using the Z-scores of registered HC measurements we defined the variables: HC Minimum, HC Drop and HC Catch-up. We classified patients according to the presence or absence of intellectual disability (IQ below 71) and according to the cause of microcephaly (idiopathic, familial, syndromic, symptomatic and mixed). Results: Using discriminant analysis a C-function was defined as C = HC Minimum + HC Drop with a cut-off level of C = −4.32 Z-score. In our sample 95% of patients scoring below this level, severe microcephaly, were classified in the disabled group while the overall concordance was 66%. In the symptomatic-mixed group the concordance between HC function and outcome reached 82% in contrast to only 54% in the idiopathic-syndromic group (P-value = 0.0002). Conclusions: We defined a HC growth function which discriminates intellectual disability of microcephalic patients better than isolated HC measurements, especially for those with secondary and mixed aetiologies. Resumen: Introducción: Nuestro objetivo fue investigar la correlación entre patrones de crecimiento cefálico y discapacidad intelectual entre distintas presentaciones etiológicas de microcefalia. Pacientes y métodos: 3.269 gráficas de perímetro cefálico (PC) de una unidad de neuropediatría terciaria fueron revisadas y 136 participantes con microcefalia seleccionados. Utilizando las puntuaciones Z de las medidas de PC registradas definimos las variables: PC Mínimo, Caída de PC y Recuperación de PC. Los pacientes se clasificaron según la existencia o no discapacidad intelectual (CI inferior a 71) y según la causa de la microcefalia (idiopática, familiar, sindrómica, sintomática y mixta). Resultados: Mediante el uso del Análisis Discriminante se definió una función C como C = PC mínimo + Caída de PC con un nivel de corte de puntuación Z de C = −4.32. En nuestra muestra, el 95% de pacientes con resultados por debajo de este nivel, microcefalia severa, presentaban discapacidad intelectual. La concordancia global entre la función de PC y la presencia de discapacidad intelectual fue del 66%. En el grupo de sintomáticas y mixtas esta concordancia alcanzó el 82%, en contraste con sólo el 54% del grupo de idiopáticas y sindrómicas (P = 0,0002). Conclusiones: La utilización de una función de crecimiento del PC discrimina la discapacidad intelectual en pacientes con microcefalia mejor que mediciones aisladas de PC, especialmente en etiologías secundarias y mixtas.

Lactobacillus fermentum CECT5716 is a probiotic strain originally isolated from human breast milk. Previous clinical studies in infants showed that the early administration of a milk formula containing this probiotic strain was safe and may be useful for the prevention of community-acquired infections. This is a 3-year follow-up study aimed at evaluating the long-term effects produced by the early consumption of an infant formula supplemented with L. fermentum CECT5716 (experimental group, EG) compared with a control formula without the probiotic (control group, CG). The infants included in this follow-up study had previously completed a 5-month randomized double-blind controlled trial (from 1 to 6 months of age), where the safety and tolerance of the probiotic formula was evaluated. The main outcome of the follow-up study was the growth of the children. The secondary outcomes included the incidence of infectious and non-infectious diseases, parameters related with intestinal function and faecal microbiota. At 3 years, the mean values of weight, length and head circumference were similar in children of the EG compared with those of the CG. No differences were observed in the incidence of infectious and non-infectious diseases or disorders related with intestinal function. The pattern of faecal microbiota was also similar between both groups. In conclusion, this 3-year study shows that the early administration of the probiotic of L. fermentum CECT5716 in an infant formula is safe and it does not produce measurable differences in children compared with a control formula.

Background It is not yet definitively known whether dynamic features of head circumference growth are associated with autism. To address this issue, we carried out a nested matched case-control study using data from national well baby clinics in Finland; autism cases were identified from the Finnish Hospital and Outpatient Discharge Registry. Methods A nonparametric Bayesian method was used to construct growth velocity trajectories between birth and 2 years of age in autism cases and matched control subjects ( n = 468 in main analyses, 1:1 matched control subjects). Estimates of odds ratios for autism risk in relation to the growth velocities were obtained using conditional logistic regression. Results Growth velocity of head circumference at 3 months of age, adjusting for gestational age at birth and maternal age, is significantly associated with autism ( p = .014); the finding was observed in subjects with comorbid intellectual disability (ID) ( p = .025) but not in those without ID ( p = .15). Height growth velocity among subjects with autism and without ID is significantly associated with autism at 6 months ( p = .007), and weight growth velocity at 18 months without ID ( p = .02) and 24 months without ID ( p = .042) and with ID ( p = .037). Conclusions Acceleration in head circumference growth is associated with autism with comorbid ID at 3 months but not subsequently. This association is unrelated to acceleration in height and weight, which are not strongly associated with autism until after 6 months.

Objective Accurate measurement of fetal head biometry is important for fetal weight estimation (FWE) and is therefore an important prognostic parameter for neonatal morbidity and mortality and a valuable tool for determining the further obstetric management. Measurement of the head circumference (HC) in particular is employed in many commonly used weight equations. The aim of the present study was to find the most accurate method to measure head circumference for fetal weight estimation. Study design This prospective study included 481 term pregnancies. Inclusion criteria were a singleton pregnancy and ultrasound examination with complete fetal biometric parameters within 3 days of delivery, and an absence of structural or chromosomal malformations. Different methods were used for ultrasound measurement of the HC (ellipse-traced, ellipse-calculated, and circle-calculated). As a reference method, HC was also determined using a measuring tape immediately after birth. FWE was carried out with Hadlock formulas, including either HC or biparietal diameter (BPD), and differences were compared using percentage error (PE), absolute percentage error (APE), limits of agreement (LOA), and cumulative distribution. Results The ellipse-traced method showed the best results for FWE among all of the ultrasound methods assessed. It had the lowest median APE and the narrowest LOA. With regard to the cumulative distribution, it included the largest number of cases at a discrepancy level of ±10%. The accuracy of BPD was similar to that of the ellipse-traced method when it was used instead of HC for weight estimation. Conclusion Differences between the three techniques for calculating HC were small but significant. For clinical use, the ellipse-traced method should be recommended. However, when BPD is used instead of HC for FWE, the accuracy is similar to that of the ellipse-traced method. The BPD might therefore be a good alternative to head measurements in estimating fetal weight.

Numerous clinical studies over the past decades have concluded that there is an association between autism spectrum disorders (ASD) and large head size. Lately, some studies have reported conflicting results. The present study was conducted with a view to assess the presence of macrocephaly in a community-representative group of pre-school children with ASD. The prevalence of ASD in this general population was 0.8%. Thirty-three children (5 girls, 28 boys) recruited after general population screening for ASD, and diagnosed with ASD (two-thirds not globally delayed) were assessed as regards growth parameters; height, weight, and head circumference (HC), at birth and at comprehensive medical-psychiatric diagnostic examinations at a mean age of 3 years. Macrocephaly in the present study was defined as HC above the 97th percentile, and ≥ 2 SD above recorded length/height. Only one of the 33 children (3%) had macrocephaly which is similar to the general population prevalence. Another 9% had a big but proportional head. None of the children were microcephalic. In this community-based study we found no evidence to support a strong link between a large head size and ASD. Conclusions must be guarded because of the relatively small number of ASD cases included.

The evolution of hyper-prolific pig breeds has led to a higher within-litter variation in birth weight and in BW gain during the nursery phase. Based on an algorithm developed in previous research, two populations from a pool of 368 clinically healthy piglets at 6 weeks of age were selected: a low (LP) and a high (HP) performing population and their development was monitored until the end of the nursery phase (10 weeks of age). To understand the cause of the variation in growth between these populations we characterized the LP and HP piglets in terms of body morphology, behaviour, voluntary feed intake, BW gain, and apparent total tract and ileal nutrient digestibility. Piglets were housed individually and were fed a highly digestible diet. At selection, 6 weeks of age, the BW of LP and HP piglets were 6.8±0.1 and 12.2±0.1 kg, respectively. Compared with the LP piglets the HP piglets grew faster (203 g/day), ate more (275 g/day) from 6 to 10 weeks of age and were heavier at 10 weeks (30.0 v. 18.8 kg, all P0.10). We concluded that the low performance of the LP piglets was due to their inability to engage compensatory gain or compensatory feed intake as efficiency of nutrient utilization and feed intake per kg BW0.75 was unaffected. LP piglets tend to be more fearful towards novel objects. The morphological comparisons, increased body length and head circumference relative to BW imply that LP piglets have an increased priority for skeletal growth.

Previous research has suggested that the local processing bias often reported in studies of Autism Spectrum Condition may only be typical of a subgroup of individuals with autism also presenting with macrocephaly. The current study examined a group of children with autism, with and without macrocephaly, on the Children's Embedded Figures Test (CEFT), a well-established measure of local processing bias. The results demonstrated that the children with autism and macrocephaly performed significantly better on the CEFT than children with autism without macrocephaly, indicative of a local bias. These results lend support to the proposal that both macrocephaly in autism and a local processing bias may arise from the same underlying neural processes and these characteristics represent an endophenotype in a subgroup of individuals with ASC worthy of further investigation.

Special abilities may be common in autism spectrum disorders (ASD). The aim of this study was to investigate the clinical presentation of ASD with special abilities. Special abilities were defined based on the Autism Diagnostic Interview-Revised (ADI-R). Based on a sample of 398 children, ages 2–7 years old with ASD, 112 with special skills were compared to an age- and gender-matched group without special abilities (n = 79). The examined measures included autism symptoms severity, adaptive behaviors and head circumference percentile. Children with ASD and special abilities seemed to exhibit significantly less impaired ASD symptoms in the social, communication and stereotyped behaviors and significantly better adaptive skills than individuals with ASD without special skills. Children with ASD and special abilities had a larger head circumference percentile than children without special abilities. Special abilities occurred in 28% of the study participants. Memory skills were the most frequently reported special ability, followed by musical, visuospatial and reading skills. The authors conclude that individuals with ASD and special abilities might represent a distinct ASD subgroup with milder clinical ASD presentation. Larger head circumference in ASD was previously associated with enhanced “local” connectivity which provides detailed information processing and therefore might be related to the appearance of special abilities.

We evaluated the significance of head circumference growth velocity as related to developmental deficits during infancy. Head circumferences, lengths, and developmental diagnoses were retrieved in a standard manner at ≥ 2 time points from 437 infants with developmental deficits, and 3909 normally developing infants. Infants' ages ranged from 1-24 months, with final diagnoses ascertained at age 24 months. Increased velocity during the first 2 months in typical infants was evident in the study group during the period 2-4 months. A differential head circumference growth velocity was observed, and infants diagnosed with motor delay presented decreased velocity between ages 2-4 months, compared with infants receiving other nonmotor developmental diagnoses. These differences remained after controlling for birth weight and length. No significant sex effect was evident. Infants with developmental deficits demonstrate delayed acceleration of head circumference velocity, compared with typical infants in the first 2 months. Infants with motor delay manifest decreased velocity, compared with infants presenting other developmental deficits. These differences may be related to delayed white matter maturation.

Studies of pregnancies complicated by preeclampsia led to the suggestion that the surface of the placenta is aligned along two axes, measured by its breadth and length. It was hypothesised that tissue along the breadth serves as a nutrient sensor, responding to the mother's nutritional state and fetal nutritional demands, while tissue along the length has different functions. To develop this hypothesis we measured the breadth and length of the placental surface in 401 neonates born in the King Khalid Hospital, Riyadh, Saudi Arabia, and related these measurements to the baby's body size. The breadth and length of the placental surface were highly correlated (coefficient = 0.7). Nevertheless, in a simultaneous regression with both measurements, only the breadth was associated with neonatal body size. There were strong trends of increasing birth weight, ponderal index, and the circumferences of the head, chest, abdomen and thigh with increasing placental breadth. In contrast no measurement of baby's body size was related to placental length. Birth weight increased by 125 g per cm increase in placental breadth (95% confidence interval 88 to 162, p0.001) but only by 20 g per cm increase in placental length (-13 to 53, p = 0.2). The corresponding figures for head circumference were 0.28 cm (0.17-0.39, p0.001) and 0.03 (-0.07 to 0.14, p = 0.5). The associations between placental breadth and neonatal body size were strongest if the mother's height was below the median (157 cm). The associations between a larger breadth of the placental surface and a larger baby are consistent with the hypothesis that tissue along the breadth plays a key role in nutrient transfer from mother to baby. Mothers who are short in stature are known to have lower rates of protein turnover in pregnancy. In these circumstances the ability of the placenta to transfer amino acids to the fetus may be critical.

This retrospective study aims to describe head circumference (HC) developmental course during the first year of life in 50 Italian children with autism spectrum disorder (ASD) and in a control group of 100 typically developing children (TD). To this end, we use anthropometric measurements (HC, body height, body weight) obtained at birth (T0), 1-2 months (T1), 3-5 months (T2) and 6-12 months (T3) from paediatricians and reported in the infant's 'baby book'. Data indicate that at T2 and T3 HC was significantly greater in ASD group compared to TD, while from T1 weight was significantly smaller in ASD subjects compared to healthy infants. After controlling for weight and height, ASD HC shows an excessive rate of growth from birth. The abnormal HC growth is present in the majority of infants with ASD and could represent a biomarker that together with other clinical signs might promote an early ASD identification.

Rapid growth rates of head circumference and body size during infancy have been reported to predict developmental pathologies that emerge during childhood.This study investigated whether growth in head circumference was concordant with growth in body length.Forty infants (16 males) were followed between the ages of 2 days and 21 months for durations ranging from 4 to 21 months (2616 measurements).Longitudinal anthropometric measurements were assessed weekly (n=12), semi-weekly (n=24) and daily (n=4) during home visits. Individual head circumference growth was investigated for the presence of saltatory patterns. Coincident analysis tested the null hypothesis that head growth was randomly coupled to length growth.Head circumference growth during infancy is saltatory (p0.05), characterized by median increments of 0.20 cm (95% confidence interval, 0.10-0.30 cm) in 24-h, separated by intervals of no growth ranging from 1 to 21 days. Daily assessments identified that head growth saltations were coupled to length growth saltations within a median time frame of 2 days (interquartile 0-4, range 1-8 days). Assessed at semi-weekly and weekly intervals, an average 82% (SD 0.13) of head growth saltations was non-randomly concordant with length growth (p≤0.006).Normal infant head circumference grows by intermittent, episodic saltations that are temporally coupled to growth in total body length by a process of integrated physiology that remains to be described.

Background: There is an association between rapid growth in early life and overweight in childhood. This adverse association needs to be balanced against potential beneficial effects on cognitive functioning observed in children who are born small for gestational age (SGA).Objective: We examined potential beneficial effects of rapid growth on cognitive functions in non-SGA children.Design: We performed a systematic literature search of 3 databases. In addition, we analyzed data from the Avon Longitudinal Study on Parents and Children (ALSPAC). The association of rapid weight or length gain (defined as an increase of >0.67 in the SD score of weight or length between birth and the age of 25 mo) on intelligence quotient (IQ) measurements at 49 mo and 8 y (n = 836 and n = 701, respectively) was assessed in linear models adjusted for potential confounders.Results: We identified 14 studies that assessed associations between any kind of early weight gain and cognitive outcome and that included non-SGA children. No study explicitly examined the effect of rapid weight gain. In the ALSPAC data, there was no positive association between rapid weight gain and IQ scores at either 49 mo [effect estimate (95% Cl): -1.4 (-3.6, 0.7)] or 8 y [-0.8 (-3.4, 1.9)] in non-SGA children. Subgroup analyses with stratification by sex of the children yielded similar results, as did analyses with rapid length gain. Supplementary analyses showed no linear association between weight gain and IQ.Conclusion: We showed no evidence that proposed adverse effects of rapid growth regarding later overweight will be counterbalanced by beneficial effects on cognitive functions in non-SGA children. Am J Clin Nutr 2010;92:585-93.

The primary goal of this study was to compare the size and depth of the internal jugular vein (IJV) and the subclavian vein (SCV) in infants under general anaesthesia. A secondary goal was to determine the correlation of weight, height, head circumference, and age to the size and depth of these veins.Sixty small infants weighing from 1.4 to 4.5 kg were included. Using ultrasound, the diameters via short-axis (SAX) and long-axis (LAX) views, cross-sectional area (CSA), and depth of the left and right IJV and SCV were measured.The diameter of the IJV was 7.9% larger on average than that of the SCV as measured via the SAX and LAX views (mean: 3.1 vs 2.9 mm; Wilcoxon's signed-rank test: P0.01). The CSA of the IJV was 27% larger on average than that of the SCV (mean: 10.2 vs 8.0 mm(2); Wilcoxon's signed-rank test: P0.01). Seventy-five per cent of the neonates showed a larger CSA of the IJV. The SCV was 8.4% deeper on average from the skin surface than the IJV (mean: 6.4 vs 5.9 mm; Wilcoxon's signed-rank test: P0.01). There was a significant positive correlation between weight, height, head circumference, and age to the size and depth of the veins (Spearman's rank correlation: P0.01).Because of its most likely larger size, the IJV can be recommended as the better choice for cannulation in comparison with the SCV. However, other factors should also be considered.

Introduction/Background The SBS constitutes one of the most severe paediatric head traumas. Objective When an SBS diagnosis is confirmed, take up a survey of how many children showed previous signs suggesting violence. Material and method The study spanned over 50 legal cases on child abuse from 2011 to 2015. For each case, from all medical and legal information, we established if there were previous signs of violence, which they were and when they appeared. Results The average age at the date of diagnosis was 5 months. Signs of previous violence were found among 80% of children; 42.5% had been admitted to emergency services and 67.5% had been examined by a general practitioner or a paediatrician when signs could already been noticed. The signs were: unusual vomiting without fever or diarrhoea in 64% of cases (isolated in ¼ of cases), a break in the growth chart of head circumference (45%) or in the growth chart of weight (25%), bruises (34%), an occurrence of faintness (17%). The mean age of these signs related to the occurrence of the episode leading to the diagnosis was 30 days (SD 32 days; median line 20 days). It was of at least 45 days in 25% of cases. Conclusion These results are evocative of a very frequent reiteration of violence; it is not in this case “a clap of thunder in a calm sky”. They also show the great difficulty most professionals run into when they want to speak of violence and set its diagnosis, above all when the signs are not obvious. Yet the earliest possible detection of the first signs of violence is the best to prevent reiteration and to protect the child. Lack of knowledge in this field may be an explanation and is detrimental to children. Better training for everyone is the key.