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Automatic computerized segmentation of fetal head from ultrasound images and head circumference (HC) biometric measurement is still challenging, due to the inherent characteristics of fetal ultrasound images at different semesters of pregnancy. In this paper, we proposed a new deep learning method for automatic fetal ultrasound image segmentation and HC biometry: deeply supervised attention-gated (DAG) V-Net, which incorporated the attention mechanism and deep supervision strategy into V-Net models. In addition, multi-scale loss function was introduced for deep supervision. The training set of the HC18 Challenge was expanded with data augmentation to train the DAG V-Net deep learning models. The trained models were used to automatically segment fetal head from two-dimensional ultrasound images, followed by morphological processing, edge detection, and ellipse fitting. The fitted ellipses were then used for HC biometric measurement. The proposed DAG V-Net method was evaluated on the testing set of HC18 (n = 355), in terms of four performance indices: Dice similarity coefficient (DSC), Hausdorff distance (HD), HC difference (DF), and HC absolute difference (ADF). Experimental results showed that DAG V-Net had a DSC of 97.93%, a DF of 0.09 ± 2.45 mm, an AD of 1.77 ± 1.69 mm, and an HD of 1.29 ± 0.79 mm. The proposed DAG V-Net method ranks fifth among the participants in the HC18 Challenge. By incorporating the attention mechanism and deep supervision, the proposed method yielded better segmentation performance than conventional U-Net and V-Net methods. Compared with published state-of-the-art methods, the proposed DAG V-Net had better or comparable segmentation performance. The proposed DAG V-Net may be used as a new method for fetal ultrasound image segmentation and HC biometry. The code of DAG V-Net will be made available publicly on https://github.com/xiaojinmao-code/. [ABSTRACT FROM AUTHOR]

Objective: To determine the potential impact of prenatal buprenorphine exposure on head circumference at birth and analyze whether head circumference may be related to maternal buprenorphine dose at delivery, delayed maternal entry into buprenorphine treatment or exposure to a variety of other medications and substances.Methods: A retrospective cohort study was performed of 137 full-term infants exposed to buprenorphine during pregnancy from January 2013 to December 2017. Pearson's correlation was calculated to investigate the potential relationship between head circumference and maternal dose of buprenorphine at delivery. t-tests were conducted to analyze head circumference in relationship to dichotomous variables.Results: Head circumference in infants exposed to buprenorphine during pregnancy was not significantly different from national norms for either male infants (95% CI 28.2-33.5 cm, norm 31.5 cm, and 28.5-34.9 cm, norm 33.1 cm, for the 3rd and 10th percentile, respectively) or female infants (95% CI 28.7-32.8 cm, norm 31.9 cm, and 29.1-34.3, norm 32.8 cm for the 3rd and 10th percentile, respectively). Head circumference was not associated with delayed maternal entry into buprenorphine treatment (t = -1.0715, p = .287) or exposure to psychotropic medications during pregnancy (t = 0.4194, p = .677). There was no relationship between infant head circumference and maternal buprenorphine dose at delivery (r = 0.004, p = .967). Head circumference was not associated with maternal smoking (t = 0.003, p = .998) or exposure to marijuana (t = 0.7277, p = .468), illicit opioids (t = -0.6701, p = .504), illicit amphetamines (t = -0.4062, p = .687) or illicit benzodiazepines (t = -0.6288, p = .535) during pregnancy.Conclusions: Exposure to buprenorphine prenatally does not appear to be associated with reduced head circumference at birth. Head circumference at birth also does not appear related to either maternal buprenorphine dose at delivery or delayed entry into treatment. As previous literature suggests that high dose methadone exposure during pregnancy may be associated with smaller head circumference and that smaller head circumference may be associated with risk of neurocognitive disorders, our results further support the use of buprenorphine as a first line treatment for opioid use disorders during pregnancy. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate lamb birth weight based on body dimensions. We monitored 101 lambs (61 Charollais lambs, 27 Kent lambs, and 13 their crossbreds) at a selected commercial flock. Birth weight, chest circumference (CC), head circumference (HC), and shin circumference (SC) were measured immediately after birth using a tape measure. Correlation analysis indicated the promising use of CC (r = 0.795; p <.001) or HC (r = 0.679; p <.001) for estimating body weight. Statistical models with one body measurement indicated that a model with CC as a covariate had the highest coefficient of determination and the lowest Akaike's information criterion, corrected Akaike's information criterion, and Bayesian information criterion. The defined criteria generally identified that models with SC, HC, and CC and models with HC and CC as covariates were the best. Residual analyses verified our results, but more extensive analyses of other breeds under different breeding conditions should be conducted to confirm and generalise our results. Statistical models have been proposed to predict the birth weight of lambs. Tape measure can be successfully used for birth weight estimation. Model with chest, head, shin circumferences as covariates were suggested. [ABSTRACT FROM AUTHOR]

General mental ability is a terminology that represents an individual level of learning, perceiving command, and resolve problems. Objectives of the present study are to assess the mental ability of children’s belonging to different socio-economic class; to examine the sexual difference in general mental ability and head size and to find the relationship between head size and general mental ability. The study was conducted among 100 (50 boys and 50 girls) of fifth standard children’s at schools of Bhatgaon cluster, Baloda Bazar, Chhattisgarh. The general mental ability is assessed by General Mental Ability Test for children (GMATC) and the mathematical analysis was carried out using Statistical Package for Social Sciences (SPSS 16.0). The maximum number of children’s belongs to upper lower socio-economic class and dolichocephalic head size. Out of 100 children’s 26 were outstanding, 25 were excellent, 20 were very good, 18 were good and 11 children’s came in the category of scope for improvement. There is no significant sexual difference in general mental ability (t= 0.06; p<0.05)and cephalic index(t= -0.84; p<0.05). Head circumference shown a significant difference (t= 3.00;p<0.05). Significant weak correlation (r=0.255; p<0.05)) was found between head size and general mental ability. Significant medium correlation (r= 0.588; p<0.01) was observed between parental socio-economic-educational status and general mental ability. [ABSTRACT FROM AUTHOR]

Objectives: In the present study, we introduced a practical approach to quantify organ-specific radiation doses and investigated whether low-dose head circumference (HC)-based protocols for non-enhanced head computed tomography (CT) could reduce organs-specific radiation dose in pediatric patients while maintaining high image quality. Methods: A total of 83 pediatric patients were prospectively recruited. Without limits to the HC, 15 patients were selected as a convention group (CON group) and underwent non-enhanced head CT scan with standard-dose protocols (tube current-time products of 250mAs). Low-dose group (LD group), including remaining 68 pediatrics were divided into 3 subgroups based on the HC: 54.1-57.0 cm for LD200mAs group (HC-based protocols of 200mAs), 51.1-54.0 cm for LD150mAs group (HC-based protocols of 150mAs), 48.1-51.0 cm for LD100mAs group (HC-based protocols of 100mAs). Subjective and objective image quality was evaluated and measured by 2 experienced radiologists. Radimetrics was used to calculate organs-specific radiation dose, including the brain, eye lenses, and salivary glands. Results: In CON250mAs group, radiation doses in the brain and salivary glands were conversely correlated with HC, and pediatric patients with smaller HC received higher organs-specific radiation dose. Reducing tube current-time product from 250 to 100mAs could significantly reduce the organ-specific radiation dose. The subjective image quality score ≥ 3.0 is acceptable for diagnosis purposes. The signal to noise ratio (SNR) and the contrast to noise ratio (CNR) of bilateral thalamus and centrum semiovale in 3 LD subgroups were not statistically different compared with the CON group. Conclusion: Our research indicated that low-dose HC-based protocols of non-enhanced head CT scan can evidently reduce the organ-specific radiation doses, while maintaining high image quality. HC can serve as a vital tool to guide personalized low-dose head CT scan for pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Optimal management of fetuses diagnosed as small for gestational age based on an estimated fetal weight of <10th percentile represents a major clinical problem. The standard approach is to increase fetal surveillance with serial biometry and antepartum testing to assess fetal well-being and timing of delivery. Observational studies have indicated that maternal rest in the left lateral position improves maternal cardiac output and uterine blood flow. However, maternal bed rest has not been recommended based on the results of a randomized clinical trial that showed that maternal rest does not improve fetal growth in small-for-gestational-age fetuses. This study was conducted to revisit this question., Objective: This study aimed to determine whether maternal bed rest was associated with an increase in the fetal biometric parameters that reflect growth after the diagnosis of a small-for-gestational-age fetus., Study Design: A retrospective study was conducted on fetuses who were diagnosed as small for gestational age because of an estimated fetal weight of <10th percentile for gestational age. The mothers were asked to rest in the left lateral recumbent position. Fetal biometry was performed 2 weeks after the diagnosis. All fetuses before entry into the study had a previous ultrasound that demonstrated an estimated fetal weight of >10th percentile. To assess the response to bed rest, the change in fetal biometric parameters (estimated fetal weight, head circumference, abdominal circumference, and femur length) after the recommendation of bed rest was computed for 2 periods: (1) before the diagnosis of a weight of <10th percentile vs at the time of diagnosis of a weight of <10th percentile and (2) at the time of diagnosis of a weight of <10th percentile vs 2 weeks after maternal bed rest. For repeated measures, proportions were compared using the McNemar test, and percentile values were compared using the Bonferroni Multiple Comparison Test. A P value of <.05 was considered significant. To describe changes in the estimated fetal weight without bed rest, 2 control groups in which the mothers were not placed on bed rest after the diagnosis of a small-for-gestational-age fetus were included., Results: A total of 265 fetuses were observed before and after maternal bed rest. The following were observed in this study: (1) after 2 weeks of maternal rest, 199 of 265 fetuses (75%) had a fetal weight of >10th percentile; (2) the median fetal weight percentile increased from 6.8 (interquartile range, 4.4-8.4) to 18.0 (interquartile range, 9.5-29.5) after 2 weeks of bed rest; (3) similar trends were noted for the head circumference, abdominal circumference, and femur length. In the groups of patients who were not asked to be on bed rest, a reassignment to a weight of >10th percentile at a follow-up examination only occurred in 7 of 37 patients (19%) in the Texas-Michigan group and 13 of 111 patients (12%) in the Colorado group compared with the bed rest group (199/265 [75%]) (P<.001)., Conclusion: Patients who were prescribed 2 weeks of bed rest after the diagnosis of a fetal weight of <10th percentile had an increase in weight of >10th percentile in 199 of 265 fetuses (75%). This increase in fetal weight was significantly higher than that in the 2 control groups in which bed rest was not prescribed. This observation suggests that bed rest improves fetal growth in a subset of patients., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Preterm infants who leave the intrauterine environment early are deprived of tactile stimuli. This affects the physical, emotional and social developments of infants and their physical growth parameters such as weight, height and head circumference negatively., Aim: This research was conducted to determine the effects of massage on the development of preterm infants., Material-Method: This research was conducted as randomized controlled research with two groups (massage-control). The infants in the intervention group received massage for 30 days. Height, weight and head circumference values of the infants were recorded on days 5, 10, 20 and 30. Amount of feeding was recorded before intervention, on day 15 after intervention and on day 30 after intervention. Discharge times of the infants were recorded according to groups., Results: A significant difference was found in height and weight of the preterm infants on days 20 and 30 when compared with the control group. Discharge time of the infants in the massage group was found to be 10 days shorter on average when compared with the control group. Significant difference was also found between day 15 and 30 in terms of amount of feeding., Conclusion: Massage was found to have significant effects on physical growth parameters such as height, weight and head circumference. It was found that massage increased amount of feeding and weight intake in infants and decreased discharge time. In this case, hospital cost per infant may be reduced., (Copyright © 2023. Published by Elsevier Inc.)

Introduction: Human physical growth, biological maturation, and intelligence have been documented as increasing for over 100 years. Comparing the timing of secular trends in these characteristics could provide insight into what underlies them. However, they have not been examined in parallel in the same cohort during different developmental phases. Thus, the aim of this study was to examine secular trends in body height, weight, and head circumference, biological maturation, and intelligence by assessing these traits concurrently at four points during development: the ages of 4, 9, 14, and 18 years., Methods: Data derived from growth measures, bone age as an indicator of biological maturation, and full-scale intelligence tests were drawn from 236 participants of the Zurich Longitudinal Studies born between 1978 and 1993. In addition, birth weight was analyzed as an indicator of prenatal conditions., Results: Secular trends for height and weight at 4 years were positive (0.35 SD increase per decade for height and an insignificant 0.27 SD increase per decade for weight) and remained similar at 9 and 14 years (height: 0.46 SD and 0.38 SD increase per decade; weight: 0.51 SD and 0.51 SD increase per decade, respectively) as well as for weight at age 18 years (0.36 SD increase per decade). In contrast, the secular trend in height was no longer evident at age 18 years (0.09 SD increase per decade). Secular trends for biological maturation at 14 years were similar to those of height and weight (0.54 SD increase per decade). At 18 years, the trend was non-significant (0.38 SD increase per decade). For intelligence, a positive secular trend was found at 4 years (0.54 SD increase per decade). In contrast, negative secular trends were observed at 9 years (0.54 SD decrease per decade) and 14 years (0.60 SD decrease per decade). No secular trend was observed at any of the four ages for head circumference (0.01, 0.24, 0.17, and - 0.04 SD increase per decade, respectively) and birth weight (0.01 SD decrease per decade)., Discussion: The different patterns of changes in physical growth, biological maturation, and intelligence between 1978 and 1993 indicate that distinct mechanisms underlie these secular trends., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Eichelberger, Chaouch, Rousson, Kakebeeke, Caflisch, Wehrle and Jenni.)

Objective: The need for permanent CSF diversion is lower in patients who have undergone prenatal surgery for myelomeningocele (MMC) than in those who have undergone postnatal closure. Differences in brain development and head growth between treatment groups are not known, particularly for those who do not require surgical treatment for hydrocephalus. The objective of this study was to determine differences in head growth and to generate MMC-specific head circumference (HC) growth curves for patients who underwent either prenatal or postnatal surgery., Methods: The authors retrospectively identified patients from St. Louis Children's Hospital who were treated for MMC between 2016 and 2021. HC data were obtained from birth until the most recent follow-up or hydrocephalus treatment. Nonlinear least-squares regression analysis was performed to fit the data into four models: two-term power, Gompertz, West ontogenetic, and Weibull. Subsequently, the curves were assessed for their utility in predicting hydrocephalus treatment., Results: Sixty-one patients (29 females [47.5%], 25 [41%] underwent prenatal surgery, mean gestational age at birth 36.6 weeks) were included in the study. The Weibull model best fit the HC data (prenatal adjusted R2 = 0.95, postnatal adjusted R2 = 0.95), while the Gompertz model had the worst fit (prenatal adjusted R2 = 0.56, postnatal adjusted R2 = 0.39) across both cohorts. Prenatal MMC repair patients had significantly larger HC measurements than their postnatal repair counterparts. The 50th percentile of the Weibull curve was determined as a useful threshold for hydrocephalus treatment: children with HC measurements that crossed and remained above this threshold were significantly more likely to have hydrocephalus treatment regardless of time of MMC repair (prenatal relative risk [RR] 10.0 [95% CI 1.424-70.220], sensitivity 85.7% [95% CI 0.499-0.984], and specificity 82.4% [95% CI 0.600-0.948]; postnatal RR 4.750 [95% CI 1.341-16.822], sensitivity 90.5% [95% CI 0.728-0.980], and specificity 75.0% [95% CI 0.471-0.924]). The HC growth curves of the MMC patients treated prenatally were significantly larger than the WHO HC curves (p < 0.001)., Conclusions: The Weibull model was identified as the HC growth curve with the best fit for MMC patients and serves as a useful predictor of hydrocephalus treatment. For MMC patients with hydrocephalus, prenatal repair patients fit the model well but postnatal repair patients did not, potentially indicating different mechanisms of hydrocephalus development. Those treated prenatally had significantly larger HC measurements compared with both the general population and those treated postnatally. Further study is needed to understand the long-term cognitive outcomes and optimal management of clinically asymptomatic patients with large HC measurements who were treated prenatally for MMC.

Human milk (HM) is a complex and dynamic biological fluid, which contains appreciable concentrations of the glucocorticoids, cortisol and cortisone. Experimental studies in non-human primates suggest the HM glucocorticoids' impact on infant growth and body composition. In this current study, analysis is made of the relationships between HM glucocorticoid concentrations and the infant growth and development over the first year of life. HM was collected by lactating healthy women (n = 18), using a standardized protocol, at 2, 5, 9, and 12 months after childbirth. Cortisol and cortisone concentrations in the HM were measured using liquid chromatography mass spectrometry. Infant weight, length and head circumference were measured by standard protocols and percentage fat mass (% FM) determined by whole body bioimpedance. Cortisol and cortisone concentrations were unaltered over the analyzed lactation period (2–12 months), and were altered by infant sex. Although, HM cortisol was positively associated with infant percentage fat mass (% FM) (p = 0.008) and cortisone positively associated with infant head circumference (p = 0.01). For the first 12 months of life, the concentration of HM glucocorticoids levels was positively associated with infant adiposity (%FM) and head circumference. This preliminary evidence provides insight to a possible relationship between ingested HM glucocorticoids and infant body composition. Further studies are required to determine the mechanisms regulating HM glucocorticoids.

Introduction: Prevalence of vitamin D deficiency has been reported from all over the world since lower levels of vitamin D has been one of word’s problem in the 21st century; especially pregnant women are the most prominent one. Objectives: This study aims to investigate the relationship between mothers’ vitamin D level with infants’ birth-weight and head circumference. Patients and Methods: A cross-sectional study was conducted in the department of obstetrics and gynecology of Akbarabadi hospital during 2017-2018. Regarding two groups, infants’ three main characteristics including their weight, head circumference and height were studied. Results: The mean blood levels of vitamin D in mothers with normal-born neonates were 15.23 ± 7.14 (ng/ mL) and in the mothers who gave birth to low-birth weight were 10.02 ± 8.06 (ng/mL), which was significantly lower than the mothers of normal-weight infants (P=0.018). The mean blood levels of vitamin D in mothers who gave birth to a normal head circumference neonate were 16.07 ± 8.1 (ng/mL) and in mothers with infants’ head circumference of less than 33 cm, was 9.87 ± 7.57 (ng/mL), which was significantly lower from mothers of normal-head circumference infants (P=0.007). The serum levels of vitamin D in mothers with normal-height infants were 14.74 ± 7.52 (ng/mL) and in the mothers with a height of less than 47 cm were 15.17 ± 7.91 (ng/mL), that does not suggest any significant difference (P=0.341). The mean serum vitamin D level in mothers who had normal vaginal delivery was lower than those with cesarean delivery, however there was no significant difference (P=0.174). Conclusion: Nutrition improvement and prescribing vitamin D supplements can positively be effective in the way of curbing low-birth weight infants. Moreover, Exposure to sunlight and letting rays strike skin is essential for maintaining a healthy vitamin D status for girls and women.

Vitamin D deficiency during pregnancy has been associated with poor foetal growth and neonatal birth anthropometry. However, the associations were inconsistent and could be confounded by neonatal vitamin D status and genetic factors. Until recently, limited studies have concomitantly examined the effect of maternal and neonatal vitamin D deficiency and vitamin D-related single nucleotide polymorphisms (SNPs) on neonatal birth anthropometry. This study aims to examine the independent and combined effects of maternal and neonatal vitamin D deficiency and vitamin-D-related SNPs on neonatal birth anthropometry. This cross-sectional study included 217 mother–neonate dyads recruited from Hospital Serdang, Selangor, Malaysia, between 2015 and 2017. Plasma 25-hydroxyvitamin D (25OHD) concentration was measured in maternal and umbilical cord blood using ultra-high-performance liquid chromatography (UHPLC). Maternal and neonatal vitamin D Receptor (VDR) SNP (rs2228570) genotypes were determined using high-resolution melting (HRM). Group-specific component (GC) SNPs (rs4588 and rs7041) genotypes were determined using restriction fragment length polymorphism. Our results showed that: (1) maternal vitamin D deficiency (25OHD < 30 nmol/L) was inversely associated with birth weight, head circumference and crown–heel length; (2) neonatal SNPs, VDR rs2228570 and GC rs4588, were significantly associated with birth weight and head circumference, respectively; and (3) a potential interaction was observed between maternal VDR rs2228570 with maternal vitamin D deficiency on head circumference. These findings suggest that the underlying mechanisms of vitamin D on foetal growth are likely to be localised in the maternal compartment, mediated through the placenta, rather than through cellular mechanisms within the foetus. Further large-scale studies are warranted to validate and extend these findings.

The fetus head circumference (HC) is a key biometric to monitor fetus growth during pregnancy, which is estimated from ultrasound (US) images. The standard approach to automatically measure the HC is to use a segmentation network to segment the skull, and then estimate the head contour length from the segmentation map via ellipse fitting, usually after post-processing. In this application, segmentation is just an intermediate step to the estimation of a parameter of interest. Another possibility is to estimate directly the HC with a regression network. Even if this type of segmentation-free approaches have been boosted with deep learning, it is not yet clear how well direct approach can compare to segmentation approaches, which are expected to be still more accurate. This observation motivates the present study, where we propose a fair, quantitative comparison of segmentation-based and segmentation-free (i.e., regression) approaches to estimate how far regression-based approaches stand from segmentation approaches. We experiment various convolutional neural networks (CNN) architectures and backbones for both segmentation and regression models and provide estimation results on the HC18 dataset, as well agreement analysis, to support our findings. We also investigate memory usage and computational efficiency to compare both types of approaches. The experimental results demonstrate that even if segmentation-based approaches deliver the most accurate results, regression CNN approaches are actually learning to find prominent features, leading to promising yet improvable HC estimation results.

Introduction: Low Birth Weight (LBW) is associated with poor health conditions during neonatal period, infancy and in adult life. It is possible that some form of fetal growth restriction occurs in babies of HIV sero-positive women. Aim: To determine the effect of maternal HIV infection on neonatal birth weight and other neonatal anthropometric indices. Materials and Methods: The study was prospective cohort in design. Neonatal birth weight, head circumference, and crownheel length of babies of 87 consecutive consenting HAART experienced HIV sero-positive pregnant women on HAART (study group) were compared with those of 92 matched HIV sero-negative women (control group). Data analyses were both descriptive and inferential at 95% confidence level. Results: The incidence of low birth weight was 25.3% (22/87) among the HIV sero-positive group and 14.1% (13/92) among the control group (p=0.060, R.R=1.8, 95% CI: 0.96-3.33). The mean neonatal head circumference in the study and control groups were 33.7±2.93 cm and 34.5±2.31 cm respectively, p=0.036 while the mean crown-heel length was 47.9±4.59 cm versus 48.7±4.02 cm, p=0.217. Conclusion: Maternal HIV treatment with Highly Active Antiretroviral Therapy (HAART) was not associated with high incidence LBW in Enugu, Nigeria. However, the head circumference was reduced. Careful measurement of the head circumferences of neonates of HIV sero-positive mothers, during routine new-born examination, is encouraged, so that any disproportionate growth would receive further appropriate assessment.

Neonatal growth indices are one of the important issues in the assessmentand care of pregnancy which have significant effects on the life after birth.Therefore, it is important to recognize their related factors. The aim of thisstudy was to investigate the relationship between pregnant women's lifestyleand physical growth indices in newborns. This descriptive-comparativestudy was conducted on 412 pregnant women (mean age 28.1±5.6 years)who referred to Mahdieh Hospital in Tehran by a cross-sectional and fieldmethod. Subjects were selected by convenience sampling method. Data werecollected and recorded by Lifestyle Questionnaire (LSQ) and informationabout the growth indices of newborns from their medical records in TehranMahdieh Hospital. Then, growth indices were compared with NCHSstandard norm (P≤0.05). Independent and one-sample t tests and Pearsoncorrelation were used to analyze the data. According to the results, thequality of lifestyle in pregnant women was reported to be moderate. Also, acomparison of weight and height indices showed a significant difference inthe time intervals after birth in comparison with the NCHS norm (P≤0.05)which indicated that this norm was lower than the global norm in Iranianinfants. On the other hand, no significant difference was observed in thehead circumference (P=0.18). Considering the findings of this study onlifestyle and moderate physical activity in pregnant women, mothers arerecommended to have more physical activity and to improve their nutritionalquality so that they can promote their lifestyle and thereby improve thegrowth indices of newborns.

Abstract Background Sedentary behavior is associated with adverse health outcomes in the general population. Whether sedentary behavior during pregnancy is associated with newborn outcomes, such as birth size, is not established, and previous studies have been inconsistent. While previous research suggests that male and female fetuses respond differently to maternal behaviors, such as physical activity, the role of infant sex in sedentary behavior-birth size associations has not been examined. Methods Participants in the Omega study, a cohort in Washington State (1996–2008), reported leisure time sedentary behavior (non-work time spent sitting), light intensity physical activity, and moderate/vigorous leisure time physical activity duration in the year before pregnancy (N = 1373) and in early pregnancy (N = 1535, mean 15 weeks). Offspring birth size was abstracted from delivery records. Non-parametric calibration weighting was used to assign adjustment weight (matching the distribution of sociodemographic and medical characteristics of the full cohort (N = 4128)) to participants with available sedentary behavior data. Weighted linear regression models were used to estimate mean differences in offspring birthweight, head circumference, and ponderal index (birthweight/length3) associated with leisure time sedentary behavior. Regression models were run overall and stratified by offspring sex. Isotemporal substitution modeling was used to determine mean differences in birthweight associated with replacing sedentary behavior with light or moderate/vigorous physical activity. Results On average, women spent 2.3 and 2.6 h/day in leisure time sedentary behavior during pre- and early pregnancy, respectively. There were no associations of pre-pregnancy leisure time sedentary behavior with mean birthweight, head circumference, or ponderal index (adjusted β = − 12, 95% CI: -28, 4.1; β = 0.0, 95% CI: -0.04, 0.1; and β = 0.1, 95% CI: -0.2, 0.4, respectively). Early pregnancy sedentary behavior was not associated with mean birth size. Associations of sedentary behavior with mean birth size did not differ by offspring sex. Replacing sedentary time with light or moderate/vigorous physical activity was not associated with mean birthweight. Conclusions We did not observe associations of maternal sedentary behavior during pre- or early pregnancy with mean offspring birth size. Pre-pregnancy and early pregnancy sedentary behavior may have important adverse effects on maternal health, but our results do not support associations with mean offspring birth size.

Abstract Background The measurement of maximal head circumference is a standard procedure in the examination of childrens’ cranial growth and brain development. The objective of the study was to evaluate the validity of maximal head circumference to cranial volume in the first year of life using a new method which includes ear-to-ear over the head distance and maximal cranial length measurement. Methods 3D surface scans for cranial volume assessment were conducted in this method comparison study of 44 healthy Caucasian children (29 male, 15 female) at the ages of 4 and 12 months. Results Cranial volume increased from measurements made at 4 months to 12 months of age by an average of 1174 ± 106 to 1579 ± 79 ml. Maximal cranial circumference increased from 43.4 ± 9 cm to 46.9 ± 7 cm and the ear-to ear measurement increased from 26.3 ± 21 cm to 31.6 ± 18 cm at the same time points. There was a monotone association between maximal head circumference (HC) and increase in volume, yet a backwards inference from maximal circumference to the volume had a predictive value of only 78% (adjusted R2). Including the additional measurement of distance from ear to ear strengthened the ability of the model to predict the true value attained to 90%. The addition of the parameter skull length appeared to be negligible. Conclusion The results demonstrate that for a distinct improvement in the evaluation of a physiological cranial volume development, the additional measurement of the ear-to ear distance using a measuring tape is expedient, and, especially for cases with pathological skull changes, such as craniosynostosis, ought to be conducted.

Background: Success of complete denture treatment lies in the ability to make it indiscernible from the natural. The selection of the six maxillary anterior teeth is of utmost importance as it contributes most to denture esthetics. Although various techniques and methods to determine the width of maxillary anterior teeth and its relation to various body measurements were done, the simple technique of using circumference of head has been less documented, specifically for Indian population. Aims and Objective: The aim of this study was to determine whether a relationship exists between the widths of the upper six anterior teeth to head circumference and the objective was to decide whether head circumference can be used as a deciding criterion to select size of maxillary anterior teeth for Central Indian population. Materials and Methods: This study was done on 300 people who included 135 males and 165 females. The circumference of head (A) and the combined width of the six anterior maxillary teeth (B) were measured and the ratio of A: B was determined. Results: EPO Info software version 6 was used to derive the statistical analysis with unpaired Student's t-tests. In male students, the mean of the ratio between the head circumferences to the combined widths of the anterior maxillary teeth was 10.14:1. In female students, the mean of the ratio between the head circumferences to the widths of the anterior maxillary teeth was 10.09:1. The average circumference of head to mesiodistal width of six anterior teeth ratio was concluded to be 10. Conclusion: Within the limitations of this study, the results suggest that head circumference divided by 10 can be used to select a teeth set with the resulting value as the combined mesiodistal width of six anterior teeth. This can be used as a starting point for determining the width of the anterior maxillary teeth for edentulous patients, which can be further confirmed with the esthetic appearance and with other facial measurements.

Introduction: High birth weight is strongly associated with OASIS; nevertheless, it has not been determined which biometric characteristics most affect OASIS occurrence. We aimed to evaluate the association of estimated fetal head circumference with OASIS occurrence among primiparous women delivering by unassisted vaginal delivery. Methods: A retrospective study included all primiparous women who delivered at term by spontaneous vaginal delivery from 2011–2019. Women were allocated to two groups: (1) those who experienced OASIS and (2) those who did not experience OASIS. Risk factors for OASIS were analyzed. Results: Overall, 7646 women were included in the study cohort. Of those, 119/7646 (1.6%; 95% CI, 1.3–1.9%) experienced OASIS. Sonographic head circumference and birth weight did not vary between groups. Prolonged second stage was more common in the OASIS group [23 (19%) vs. 986 (13.3%), 1.58 OR (95% CI 1.003–2.51, p = 0.04)]. Absence of epidural analgesia was more common in the OASIS group [30 (25%) vs. 1197 (15.9%), 1.8 OR (95% CI 1.1–2.7, p = 0.006)]. On multivariate logistic regression analysis, the lack of epidural analgesia and duration of second stage of labor were both independently positively associated with OASIS [adjusted OR 2.67 (95% CI 1.55–4.62), p < 0.001, adjusted OR 1.23 (95% CI 1.11–1.43), p < 0.001, respectively)]. Conclusion: Sonographic head circumference and birth weight are not associated with OASIS occurrence among primiparous women delivering by an unassisted vaginal delivery. Prolonged second stage and the use of epidural analgesia are modifiable risk factors among these women. [ABSTRACT FROM AUTHOR]

Meta-analyses of head circumference in autistic individuals exist; however, simple meta-analytic approaches are limited. Consequently, we gathered head circumference raw data of autistic (N = 2381) and typically developing participants (N = 994) by re-analysing the data from previously published studies together. The present study found no mean difference between head circumference of autistic and typically developing individuals, although simple effect analyses revealed smaller mean head circumference in autistic than typically developing females aged 12–17 months. However, compared to controls, the frequency of extreme head circumference in autistic males was greater at birth and between 60 and 100 months. In addition, the frequency of extremely small head circumference between 6 and 11 months, and extremely large head circumference between 12 and 17 months, was greater in autistic than typically developing males. For autistic females, compared to controls, extreme head circumference was more frequent between 36 and 59 months and less frequent at birth. We conclude that it is imperative to consider the effects of age and sex when investigating the relationship between autism diagnosis and head circumference. This variance was more effectively described via the approach of the present study than previous meta-analytic approaches. Summaries of studies that have measured head size in those with autism, known as meta-analyses, currently exist. However, this approach does not adequately explain extreme cases (such as those with extremely small, or extremely large, head size). Because of this, we obtained all available published data measuring head size (12 studies). The data from each study were then combined to make a larger dataset. We found that females with autism aged 12–17 months had, on average, smaller head sizes. Otherwise, average head size was not atypical in autism. However, we found that males with autism were more likely to have extreme head sizes at birth and between 60 and 100 months, a small head between 6 and 11 months, and a large head between 12 and 17 months. Females with autism were more likely to have extreme head sizes between 36 and 59 months and were less likely at birth. Our approach was able to measure the influence of age and biological sex on head size in autism, as well as the frequency of extreme cases of head size in autism. These results add to what we already know about head size in autism. [ABSTRACT FROM AUTHOR]

Aim: Our study aims to investigate whether there is a difference between the African pregnant population at 14-42 weeks of gestation and standard ultrasonographic fetal biometric measurements. Methods: This study was carried out at Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Hodan District, Mogadishu, Somalia from July 2018 to September 2018. Four hundred and eighty-six females at 14-42 weeks' gestation were evaluated. Obstetrical ultrasound was done using a 3.5 MHz convex transducer on Toshiba Aplio XG Ssa-790a. Biparietal diameter (BPD), head circumference (HC), femur length (FL), and abdominal circumference (AC) were identified and measured. Results: The median maternal age in the study sample was 26 years with the mode value of 30 years. The highest number of participants were in 38 weeks (31, 6.4%) and the lowest number of participants were in weeks 15 and 18 with 1 in each (0.2%). BPD gradually increased from a minimum of 26.0 mm at week 14 to a maximum of 95.9 mm. HC gradually increased from a minimum of 101.1 mm at week 14 to a maximum of 95.9 mm at week 42. AC increased gradually from a minimum of 76.6 mm at week 14 to a maximum of 369.2 mm at week 42. FL increased gradually from a minimum of 15.0 mm at week 14 to a maximum of 79.1 mm at week 42. Conclusion: The frequently used parameters of fetal biometry along with ultrasonographic appearance and measurements in our local population are in agreement with international studies except for HC which was lower than the Hadlock's measurement by an average of 7.8 mm. [ABSTRACT FROM AUTHOR]

Introduction: In today's advanced medical world maternal child health care the important part of the health care system and import components is estimation fetal gestational age. Gestational age is age of unborn baby, defined in weeks as beginning from first day of last menstrual period prior to conception. Trimester is period of three calendar months during a pregnancy. Clinically, the gestational period is divided into three trimesters. Estimation of gestational age and thereby forecasting expected date of delivery (EDD) is not only concern of the Individual but it is invaluable in the diagnosis of intrauterine growth retardation of fetus and obstetric planning other fetal parameters are useful Hence; we planned the present study to estimate fetal HC length for measuring the gestational age and compare it with other parameters. Material and methods: The study Correlation between gestational age and head circumference in Third trimester was carried out at Govt. Medical College and Hospital, Nanded, between July 2011 to July 2013 period . The study included 132 pregnant women the data so collected was then subjected to statistical analysis by expert statistician with the help of SYSTAT Crainsoft version 12 software. Standard statistical methods, parametric methods were used for the evaluation and significance. Results: As the value of R is 0.8612, the variation in fetal growth on the basis of Head Circumference during third trimester can be explained to the extent of 86.12%. The value of R is highly significant (Student's 't' test value = 228.92, p<0.0001, very highly significant) showing that there is statistically highly Positive or strong positive association between gestational age and head Circumference Conclusion: From the present study Head Circumference found to be statistically highly significant. The regression equations derived for growth parameter for estimating gestational age in a normally developing fetus, increase with gestational age, showed good correlation with gestational age. In Present study, Head circumference is the sensitive parameter and a result of present study was comparable with previous studies. [ABSTRACT FROM AUTHOR]

Background  Suboptimal fat intake during the early postnatal weeks significantly affects brain growth and maturation. Studies to date have focused on the quantity rather than the quality of fat intake. Objective  We hypothesized that early nutrition of premature neonates should also include optimization of the type of fat intake, and thus those receiving SMOFlipid, a balanced multicomponent lipid emulsion, would have improved head growth as measured by head circumference (HC) at discharge. Study Design  We retrospectively reviewed HC in infants weighing <1,500 g who were hospitalized for two or more weeks during a 20-month period, in which all preterm infants received fat as Lipofundin, and the following 20-month period, in which all such infants received SMOFlipid. Lipids were dosed up to 3 g/kg/day and reduced as enteral nutrition progressed. Parenteral fish oil (Omegaven) was permitted as rescue therapy during both periods. Results  Period 2 infants had better head growth (0.79 [0.69,0.90] vs. 0.75 [0.64,0.86] cm/week; p  = 0.0158). More infants reached discharge with an HC of ≥50 percentile (51 vs. 31%; p  = 0.0007), and fewer infants had an HC of ≤3 percentile (11 vs. 14%; p  = 0.023). Median length of stay was reduced by more than 1 week. A multivariable regression was performed using the weekly increase in HC as the dependent variable, and the time epoch, birth weight, gestational age, hospitalization days, and gender as independent variables. Only the time epoch and days of hospitalization were significant (both p  < 0.0001). Conclusion  Our data offer preliminary evidence of improved brain growth in those receiving a balanced lipid emulsion as compared with a soybean oil emulsion. [ABSTRACT FROM AUTHOR]

Introduction: Our main objective was to evaluate whether antenatal corticosteroids increase the risk of small head circumference in children born at term. Secondary objectives were to evaluate whether they increase the risk of small birthweight and birth length among those children.Material and Methods: A historical cohort included 275 270 live term born children between 2000 and 2013 in 175 French maternity units. The rate of head circumference below the 5th percentile among children born at term and exposed to antenatal corticosteroids was compared with that of two unexposed groups: those children born at term whose mothers had an episode of threatened preterm labor without corticosteroids and those whose mothers had neither threatened preterm labor nor corticosteroids. The association between this treatment and head circumference was evaluated by calculating adjusted risk ratios (aRRs) and their 95% confidence intervals (CIs). The main outcome measure was a head circumference below the 5th percentile at birth, adjusted for sex, and gestational age according to the Pediatric, Obstetrics, and Gynecology Electronic Records Users Association (AUDIPOG) curves. Secondary outcomes were birthweight and birth length below the 5th percentile.Results: The rate of head circumference below the 5th percentile was 5.8% (n = 3388) among children exposed to antenatal corticosteroids and 4.3% (n = 7077) and 4.6% (n = 198 462), respectively, for the two unexposed groups. After adjustment, the risk of having a head circumference below the 5th percentile did not differ between the exposed group and the two control groups (aRR 1.28, 95% confidence interval [CI] 0.97-1.69] and aRR 0.91, 95% CI 0.74-1.13). We did not find an association between antenatal corticosteroids and the rate of birthweight below the 5th percentile. Children exposed to antenatal corticosteroids had a higher risk of a birth length below the 5th percentile when compared with those not exposed to threatened preterm labor or corticosteroids.Conclusions: We found no association between antenatal corticosteroids and increased risk of head circumference below the 5th percentile in children born at term. [ABSTRACT FROM AUTHOR]

Background Pediatric hearing instrument fitting is optimally performed with individually obtained real-ear-to-coupler difference (RECD) measurements. If these measurements cannot be obtained, predicted values based on age are used. Recent evidence obtained from children aged 3-11 years suggests that head circumference (HC) may be a viable alternative or addition to age for use in RECD prediction. Purpose The purpose of the present study was to determine if HC can be used to predict RECDs in infants, children, and adults. Research Design A correlational design was used. HC and RECD values were measured in all participants. Study Sample Participants were 278 North American infants and children (136 males and 142 females) aged 1.6 months to 11 years and 109 adults (42 males and 67 females) aged 18 years to 83 years. Data Collection and Analysis After otoscopic inspection and immittance measurements were performed to assess candidacy for inclusion in the study, HC was measured twice for all participants and a single RECD measure was obtained for each participant at twelve frequencies (250 through 12500 Hz). The reliability of HC measurements was assessed with an intraclass correlation analysis. Linear regression analyses were performed with age and HC as predictor variables and RECDs as the dependent variable. Results Analysis indicated good reliability of the HC measurement. The relationships between RECD and HC were comparable with the relationships between RECD and age. Combining HC and age did not improve predictive accuracy. Conclusions HC can be used in children and adults as an alternative metric in the prediction of RECDs when individual RECDs cannot be obtained. [ABSTRACT FROM AUTHOR]

Arsenic exposure in postnatal life impacts the growth of children, but little is known about the effect of in-utero arsenic exposure on growth very early in childhood. The aim of this study was to examine the associations between in-utero arsenic exposure and the growth of infants from birth to 6 months of age using monthly follow-up data. A prospective cohort study was conducted in rural areas of Bangladesh with 108 mother-infant pairs. This study identified a negative association between in-utero arsenic exposure and head circumference of infants 1–6 months of age (coefficient = −1.20, 95% confidence interval [CI]: −1.97, −0.42), and the effect was more pronounced in the earlier ages of 1–3 months (coefficient = −0.88, 95% CI: −1.70, −0.05). Because head circumference is considered as a surrogate of brain size, our findings suggest that in-utero arsenic exposure influences brain growth during an important developmental period. [ABSTRACT FROM AUTHOR]

Objective: Recently, microcephaly has usually been misdiagnosed only by ultrasound via measurement of head circumference (HC). Therefore, the aim of this study is to find another diagnostic index to supplement the original diagnostic method of microcephaly, to improve the detection rate of fetal microcephaly and to reduce the misdiagnosis rate.Methods: We retrospectively analyzed 123 pregnant women from February 2012 to January 2017 with fetal HC less than two standard deviations (SD). The facial profile line (FPL) was determined by ultrasonography. The first method (M1) was only used HC to determine whether the fetus was microcephaly, the second one (M2) was to combine HC and FPL for the diagnosis of microcephaly. Results were classified into five orderly categories by experienced sonographers. ROC curve was drawn to evaluate the diagnostic effect.Results: Among the pregnant women, 14 cases of fetal head circumference were less than 3SD, 109 were -2SD < HC≤ -3SD. A total of 12 cases were confirmed of microcephaly by magnetic resonance imaging (MRI) or postnatal, 10 cases of HC were less than 3SD, 2 were -2SD < HC≤ -3SD. The area under the ROC curve for M1 and M2 were 0.751 and 0.983 respectively.Conclusion: The HC in combination with FPL can be used to evaluate the fetal HC and forehead development quickly, and to improve the sensitivity and specificity of diagnosing fetal microcephaly. [ABSTRACT FROM AUTHOR]

Background: Cognitive reserve (CR) and brain reserve (BR) could offer protective effects on cognition in the early stage of Alzheimer's disease (AD). However, the effects of CR or BR on cognition in individuals with subjective cognitive decline (SCD) are not clear.Objective: To explore the effects of CR and BR on cognition in subjects with SCD.Methods: We included 149 subjects from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Education was used as a proxy for CR, and head circumference was used as a proxy for BR. Multiple linear regression models were conducted to examine the effects of CR and BR on cognitive scores. Furthermore, we assessed differences in effects between APOEɛ4 carriers with SCD (n = 35) and APOEɛ4 non-carriers with SCD (n = 114) and linear trends among 4 reserve levels (low BR/CR, high BR/low CR, low BR/high CR, and high BR/high CR).Results: Both CR and BR had independent positive effects on multiple cognitive measures in SCD participants, and the effects of CR were greater than those of BR. CR has positive effects on cognitive measures in both APOEɛ4 carriers and non-carriers with SCD. However, the positive effects of BR on cognitive measures were observed in APOEɛ4 non-carriers with SCD but not in APOEɛ4 carriers with SCD. Furthermore, there was a linear trend toward better cognitive performance on all cognitive measures in the BR+/CR+ group, followed by the BR-/CR+, BR+/CR-, and BR-/CR-groups.Conclusion: This study suggests that both CR and BR have the potential to delay or slow cognitive decline in individuals with SCD. [ABSTRACT FROM AUTHOR]

Objectives: Chromosomal microarray analysis (CMA) is the method of choice for genetic work-up in cases of fetal malformations. We assessed the detection rate of CMA in cases of abnormal fetal head circumference (HC). Methods: The study cohort was based on 81 cases of amniocenteses performed throughout Israel for the indication of microcephaly (53) or macrocephaly (28), from January 2015 through December 2018. We retrieved data regarding the clinical background, parental HCs and work-up during the pregnancy from genetic counseling summaries and from patients' medical records. Results: There was only one likely pathogenic CMA result (1.89%): a 400-kb microdeletion at 16p13.3 detected in a case of isolated microcephaly. No pathogenic results were found in the macrocephaly group. Most fetuses with microcephaly were female (87.8%), while the majority with macrocephaly were males (86.4%). Conclusions: The results imply that CMA analysis in pregnancies with microcephaly may carry a small yield compared to other indications. Regarding macrocephaly, our cohort was too small to draw conclusions. In light of the significant gender effect on the diagnosis of abnormal HC, standardization of fetal HC charts according to fetal gender may normalize cases that were categorized outside the normal range and may increase the yield of CMA for cases of abnormal HC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the effect of maternal anemia on the anthropometric indices of newborn. METHODOLOGY: This cross-sectional comparative study was conducted from September 2018 to August 2019 at the Department of Physiology, University of Sindh in collaboration with Liaquat University Hospital Hyderabad. Four hundred pregnant females aged between 18 to 40 years, admitted to deliver a baby at Gynae and obstetrics department, LUMHS, Hyderabad/Jamshoro were selected by purposive random sampling, women aged below 18 and above 40, with multiple pregnancies, still births, threatened abortion having history of chronic disease, and with drug abuse were excluded from study. Females aged between 18-40 who were having singleton pregnancy were included in this study. After obtaining written consent, complete blood picture (CBC) was performed, in Diagnostic and Research Laboratory LUMHS, three parameters of anthropometry which include weight, length, and head circumference of the babies were measured. RESULTS: The results were generated by using SPSS 21, for statistical data analysis. The prevalence of anemia was 206(51.5%). In anemic group 98(47.5%) babies born were low birth weight, and were less than 3rd percentile, and 15(7.2%) babies born were less than 3rd percentile length forage, the birthweight of babies in anemic mothers is 2.45kg±0.32 significantly (P. 0.0001) less than non-anemic group 3.09kg±0.66. The birth length of babies is 46.6cm ±2.30 significantly (P.0.0001) less than non-anemic group 48.1cm±1.19. Similarly, the head circumference was 32.5cm ±1.62 of the anemic mother's babies, significantly (P. 0.0001) less than non-anemic group 33.3cm±0.63. CONCLUSION: It is concluded that the maternal hemoglobin plays an important role in the intrauterine growth of the neonates, affecting their anthropometric indices significantly. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm2). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated. Results: The net volume was significantly lower in girls (p = 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p = 0.03), whereas cranial and net volume were found to be lower in infants (p = 0.04 and p = 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p = 0.01, p = 0.03, p = 0.03, and p = 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI. Conclusion: BMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children. [ABSTRACT FROM AUTHOR]

Background: Clinical research has demonstrated that brain reserve (BR) could exert positive effects on cognition for patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, the effects of BR on cognition in individuals with subjective cognitive decline (SCD) are not clear.Objective: To examine cross-sectional effects of BR on cognition in SCD populations.Methods: One hundred forty-nine subjects were studied from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Head circumference was used as a proxy of BR. Cognition was assessed across four domains (memory, executive, language, and general cognitive functions). Multiple linear regression models were conducted to examine effects of BR on cognitive scores. Furthermore, we addressed the question that whether the degree of self-perception of cognitive decline modified the effect of BR on cognitive performance in SCD subjects.Results: We found a positive effect of BR on language cognition in subjects with SCD. Furthermore, the positive effect of BR on language cognition survived in SCD participants with a low degree of self-perception of cognitive decline while disappeared in SCD participants with a high degree of self-perception of cognitive decline.Conclusion: This study suggests that BR has the potential to delay or slow down cognitive decline in SCD individuals, especially for mild SCD. [ABSTRACT FROM AUTHOR]

Background: Mowat-Wilson syndrome (MWS; OMIM #235730) is a genetic condition caused by heterozygous mutations or deletions of the ZEB2 gene. It is characterized by moderate-severe intellectual disability, epilepsy, Hirschsprung disease and multiple organ malformations of which congenital heart defects and urogenital anomalies are the most frequent ones. To date, a clear description of the physical development of MWS patients does not exist. The aim of this study is to provide up-to-date growth charts specific for infants and children with MWS. Charts for males and females aged from 0 to 16 years were generated using a total of 2865 measurements from 99 MWS patients of different ancestries. All data were collected through extensive collaborations with the Italian MWS association (AIMW) and the MWS Foundation. The GAMLSS package for the R statistical computing software was used to model the growth charts. Height, weight, body mass index (BMI) and head circumference were compared to those from standard international growth charts for healthy children.Results: In newborns, weight and length were distributed as in the general population, while head circumference was slightly smaller, with an average below the 30th centile. Up to the age of 7 years, weight and height distribution was shifted to slightly lower values than in the general population; after that, the difference increased further, with 50% of the affected children below the 5th centile of the general population. BMI distribution was similar to that of non-affected children until the age of 7 years, at which point values in MWS children increased with a less steep slope, particularly in males. Microcephaly was sometimes present at birth, but in most cases it developed gradually during infancy; many children had a small head circumference, between the 3rd and the 10th centile, rather than being truly microcephalic (at least 2 SD below the mean). Most patients were of slender build.Conclusions: These charts contribute to the understanding of the natural history of MWS and should assist pediatricians and other caregivers in providing optimal care to MWS individuals who show problems related to physical growth. This is the first study on growth in patients with MWS. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the association of sonographic fetal head circumference (HC) with obstetric anal sphincter injury (OASIS) occurrence among primiparous women who underwent vacuum-assisted delivery (VAD).Methods: A retrospective study of all primiparous women who delivered at term by VAD between 2011 and 2019 and underwent ultrasound with fetal biometry within 1 week prior to delivery. Women who suffered OASIS were compared to women without OASIS.Results: Overall, 74 of 3222 (2.3%) primiparous women suffered an OASIS. As compared with control, women with OASIS were younger (median 28 vs. 30 years, p = 0.001), had higher BMI (median 28.2 vs. 26.9 kg/m2, p = 0.03), and had a longer second stage of labor (median 190 vs. 168 min, p = 0.01). Fetal head circumference was larger in the OASIS group (mean 334 vs. 330 mm, p = 0.03), occiput posterior fetal head position was more prevalent (12 (16%) vs. 232 (7.4%), OR [95% CI]: 2.43 (1.29-4.57), p = 0.004), and the rate of mediolateral episiotomy performed was lower (58 (78.0%) vs. 2777 (88.2%), OR [95% CI]: 0.48 (0.27-0.85), p = 0.01). Multivariate regression modeling identified higher fetal HC (aOR [95% CI] 1.03 (1.001-1.06), p = 0.04) and occiput posterior (aOR [95% CI] 2.5 (1.16-5.71), p = 0.01) as independently positively associated with OASIS. Mediolateral episiotomy and maternal age were independently negatively associated with an OASIS (aOR [95% CI] 0.39 (0.18-0.85), p = 0.01); aOR [95% CI] 0.4 (0.17-0.60), p = 0.001).Conclusions: Sonographic large fetal HC is associated with OASIS occurrence during VAD. The only modifiable predictor of OASIS detected was mediolateral episiotomy, found to be protective against OASIS. [ABSTRACT FROM AUTHOR]

Aim: The World Health Organization (WHO) published universal growth standards for children below five year of age in 2006. Traditionally, Swedish growth references have been used to monitor growth of children in Iceland, but it is not yet known how they compare with these reference charts.Methods: A total of 2128 longitudinal measurements of length or height, 2132 of weight and 2126 of head circumference between birth and four years of age were collected in 1996-2000 from 199 healthy children (53% boys) recruited at Landspitali University Hospital. Measurements were converted to z-scores using the WHO growth standards and Swedish growth references for further analysis with mixed-effects models.Results: Length or height, weight and in particular head circumference largely exceeded the WHO standards, with average z-scores that fluctuated between 0.5 and 1.5. Likewise, the proportion of children with a z-score larger than 2 SD increased about 10-fold. Icelandic children were longer and heavier than their Swedish peers during the first six months of life, but differences were less pronounced thereafter.Conclusion: The growth of Icelandic children deviated significantly from the WHO growth standards. Although more comparable to the Swedish references, significant differences were found, suggesting that a national growth reference would be more appropriate. [ABSTRACT FROM AUTHOR]

Background: Prader-Willi syndrome (PWS) is a multisystem genetic disorder, which has a typical eating behavior and growth pattern. In the infancy period, children with PWS have low body weight followed by hyperphagia in later childhood. Disease-specific growth charts have been recommended for monitoring PWS patients. Previous literature demonstrated growth differences among individuals with PWS of different ethnicity.Methods: A retrospective multicenter study was performed in PWS patients from different areas of Thailand included collaboration with the Thai PWS support group during 2000-2017. Baseline characteristics and anthropometric data were reviewed. Both growth hormone and non-growth hormone received patients were included, but the data after receiving GH were excluded before curve construction. Growth charts for Thai PWS compared to the 50th normative centile were constructed using Generalized Least Squares (GLS) methods. Curve smoothing was performed by Fractional Polynomials and Exponential Transformation.Result: One hundred and thirteen patients with genetically confirmed PWS (55 males and 58 females) were enrolled. Fifty percent of patients were diagnosed less than 6 months of age. We developed growth charts for non-growth hormone treated Thai children with PWS aged between 0 and 18 years. A growth pattern was similar to other ethnicities while there were some differences. Mean birth weight of PWS patients was less than that of typical newborns. Mean adult height at 18 years of age in Thai children with PWS was lower than that in American children, but taller than Japanese. Mean weight of Thai PWS males at 18 years of age was more than those from other countries.Conclusion: This study is the first to document PWS-specific growth charts in Southeast Asian population. These growth charts will be useful in improving the quality of patient care and in evaluating the impact of growth hormone treatment in the future. [ABSTRACT FROM AUTHOR]

This study aims to review the epidemiological studies on the association between cadmium (Cd) exposure during pregnancy and neonatal anthropometric measures. Electronic search of PubMed, Scopus, Web of Science, and Cochrane Collaboration was conducted till end of 2018. Pooled estimates were performed using a fixed-effects model or random-effects model. A total of 22 studies included in the meta-analyses. Subgroup analyses on sample type (maternal urine, maternal blood, cord blood, and placenta), meta-regression, and sensitivity analysis were performed to seek the sources of heterogeneity. In the random-effects meta-analysis of included studies, the pooled correlation coefficient between maternal exposure to Cd with birth weight was − 0.04 [95% CI (− 0.07, − 0.01), with birth length and head circumference as − 0.01 [95% CI (− 0.04, 0.02)] and − 0.02 [95% CI (− 0.06, 0.02)]. Our findings showed significant relationship between Cd exposure of pregnant women with low birth weight, but not with birth length and head circumference. [ABSTRACT FROM AUTHOR]

Background and Objective: The Zika virus outbreak has drawn attention to microcephaly, whose definition is based on head circumference measuring below a percentile or number of SDs below the mean. The objective of this analysis was to assess how differences in measurement precision might affect prevalence and trends of microcephaly.Methods: Data from all births in Uruguay during 2010-2015 were obtained from the Perinatal Information System. The prevalence of births with microcephaly was calculated based on head circumference measurement at birth applying the INTERGROWTH-21st standards for sex and gestational age, and compared by method of ascertaining gestational age.Results: Rounding and digit preference was observed: 74% of head circumference measurements were reported as a whole centimetre value. The prevalence of births varied substantially by the criterion used to define microcephaly (<3 SD, <2 SD, <3rd percentile for gestational age) and could be halved or doubled based on adding or subtracting a half-centimetre from all reported head circumference measurements. If 4 days were added to gestational age calculations, rather than using completed gestational weeks (without days) for gestational age reporting, the prevalence was 1.7-2 times higher.Discussion: Rounding in measurement of head circumference and reporting preferences of gestational age may have contributed to a lower prevalence of microcephaly than expected in this population. Differences in head circumference measurement protocols and gestational age dating have the potential to affect the prevalence of babies reported with microcephaly, and this limitation should be acknowledged when interpreting head circumference data collected for surveillance. [ABSTRACT FROM AUTHOR]

Aim: Benign external hydrocephalus (BEH), hygroma and chronic subdural haematoma are extra-axial fluid collections in infants. MRI studies have shown that almost half of all new-borns have perinatal subdural blood, generally referred to as subdural haematoma (SDH) or perinatal SDH. Epidemiologically there are striking similarities between chronic SDH and BEH in infants.Methods: Discussion of pathophysiological mechanisms for BEH and chronic SDH, based on existing literature.Results: Perinatal SDH is common, and we hypothesise that this condition in some infants develop into extra-axial fluid collections, known as hygroma, BEH or chronic subdural haematoma. The mechanism seems to be an intradural bleeding that creates an obstructive layer preventing normal CSF absorption. The site where the bleeding originates from and those areas enveloped in blood from the primary damaged area are prone to later rebleeds, seen as 'acute on chronic' haematomas. With steady production of CSF and the blockage, increased intracranial pressure drives the accelerated skull growth seen in many of these children.Conclusion: Perinatal SDH hampers CSF absorption, possibly leading to BEH and chronic SDH, with a high risk of false accusations of abuse. Close monitoring of head circumference could prove vital in detecting children with this condition. [ABSTRACT FROM AUTHOR]

To evaluate the suitability of the new nutritional composition of renewed commercial Formula A (protein reduced to 2.2 g/100 kcal, arachidonic acid increased to 13.2 mg/100 kcal, and docosahexaenoic acid maintained at 20 mg/100 kcal), we examined whether the growth of Formula A-fed infants was equivalent to that of breastfed infants. In this observational study, 1,053 infants were followed-up to 12 months. Growth, stool consistency, and the health condition of 99 infants fed with Formula A and 295 breastfed infants were compared. Body weight, body mass index, and head circumference of Formula A-fed infants were similar to those of breastfed infants. Additionally, there were no differences in the stool consistency and the health condition (infection and allergy prevalence) between the two groups. Formula A-fed infants grew as well as breastfed infants, suggesting the appropriate nutritional composition of Formula A. The findings may contribute to further improvements in infant formulas. The equivalent growth for Formula A-fed and breastfed infants. [ABSTRACT FROM AUTHOR]

Context: Growth is an important biological process by which an individual reaches a point of complete physical development. Growth monitoring of a child is a very important utility to detect the deviation from normal growth. In India, for children below 2 years of age WHO multicentre growth reference study (MGRS) 2006 charts are being used for growth monitoring, which were prepared by measuring children from six different countries who were raised in optimum conditions of health and nutrition. Aim: This study was carried out to verify the appropriateness of the WHO MRGS 2006 charts to monitor the growth of Indian children who are below 2 years of age. Settings and Design: The study was carried out in a tertiary care hospital in Pune, Maharashtra. Materials and Methods: A total of 1947 children [1089 boys (55.9%)] were measured for weight, length and head circumference. Z score for each observed value was calculated according the similar but gender-specific WHO MGRS 2006 growth charts. Statistical Analysis Used: The age- and sex-specific Z-scores or standard deviation scores along with prevalence were obtained for each study parameter using WHO standards. Results: A total of 24.08%, 21.31%, and 20.54% of the children were classified as underweight, stunted and microcephalic respectively when compared to the WHO MGRS 2006 growth charts. Conclusion: The WHO MGRS 2006 charts may not be appropriate for growth monitoring of Indian children below 2 years of age and there is a need formulate growth charts which can reflect the growth of Indian children. [ABSTRACT FROM AUTHOR]

The achievement of optimal growth is the result of the interaction of various factors, such as genetic factor, environment, behavior and stimulation. There are several other factors that influence the increase in the infant’s weight including drugs, congenital abnormalities or chronic diseases of the infant, the sex of the infant, family socioeconomic conditions, nutrition and provision of baby massage stimulation. The study aims to assess the effectiveness of baby massage in promoting baby growth, i.e. weight, length, chest circumference and head circumference. The study uses a quasi-experiment with pretest-posttest control group design. Subjects were recruited from visitors in integrated service post (in Indonesian: Posyandu), independent midwifery practices and community health sub-centers. We collected data of baby growths in Malang regency where the residents are a homogeneous group. 30 infants were included in the study. They, subsequently, were randomly divided into experimental and control group. The experimental group babies aged 3-6 months participated in the baby massage for four weeks. The control group (N=15) was paired with the experimental group (N=15) by matching the baby’s age and sex. The growth indicators were measured two times and statistically analysed using independent t-test and eta-squared test. Growth assessment used measurement results from variable body length, weight, chest circumference, head circumference. After four weeks of massage, we found that weight, length, chest circumference and head circumference increased among babies aged 3 to 6 months who received stimulation of baby massage. Overall, the results of this study reassure that baby massage affects the growth of the infant. [ABSTRACT FROM AUTHOR]

Background: Anthropometry is a branch of anatomy. One of the important parts of anthropometry is cephalometry, which is characterized by anatomical dimensions of the head area. The aim of this study was to investigate the relationship between brain volume, weight, and IQ in children. Methods: This descriptive-analytical study was performed on 300 students. Conventional measuring instruments were used for anthropometric measurements. Body weight and skull dimensions were measured. Then, using the appropriate formulas, the volume and weight of the brain and the brain index were measured. Results: The Pearson correlation coefficient confirmed a weak correlation between the amounts of IQ and anthropometric dimension in female samples. The mean head circumference of males was 2 cm above the mean head circumference of females. Compared to the central index and the dispersion, anthropometric dimensions were significant between boys and girls. According to the analysis of neural network, the anthropometric dimensions of head height, brain weight, head width, and brain index in boys and anthropometric dimensions around the head volume of head width and head height in girls were the most important in relation to IQ. Conclusion: The results of this study showed that there was a significant statistical difference between the central index and the distribution of anthropometric dimensions in boys and girls. Moreover, there was not a significant relationship between IQ and anthropometric dimensions of the body. In girls, there was a weak correlation between IQ and head width, head height, brain volume, and brain weight. [ABSTRACT FROM AUTHOR]

Background: Our aim was to determine the prevalence of tobacco smoking and e-cigarettes and cannabis use during pregnancy, whether these were influenced by ethnicity, and their relationship to perinatal outcomes. Methods: A study was carried out in 4465 infants whose mothers delivered during 2017 and 2018. Self-reported maternal smoking, e-cigarette and cannabis use at booking were recorded. Outcome measures were birthweight and head circumference z-scores and admission to the neonatal intensive care unit (NICU). Results: Two hundred and five women reported smoking cigarettes (4.7%), five were using e-cigarettes (0.11%) and 106 were using cannabis (2.43%). Women were most likely to smoke if young (15–19 years old) or from a mixed-race or White background. Cigarette smoking was associated with a lower mean z-score for birthweight (−0.587 vs. −0.064) and head circumference (−0.782 vs. −0.157) (both outcomes P < 0.0001). Young, mixed-race women were most likely to be both smoking and using cannabis during pregnancy and their infants had a lower birthweight mean z score (−0.989 vs. −0.587, P = 0.028) and head circumference z score (−1.33 vs. 0.782, P = 0.025) than cigarette use alone. Conclusion: Young, mixed-race women were most likely to be both smoking and using cannabis during pregnancy and should be targeted for cessation programmes. [ABSTRACT FROM AUTHOR]

Background: Weight is critical for the medical management of infants; however, scales can be unavailable or inaccessible in some practice settings. We recently developed and validated a robust infant weight estimation method based on chest circumference (CC) and head circumference (HC). This study was designed to determine the human factors (HF) experience with, and predictive performance of, an infant weight estimation device that implements this method.Methods: Prospective, multi-center, observational, masked study of 486 preterm and term infants (0-90 days) assessed by 15 raters. Raters measured the infant using calibrated scales/measures and masked versions of the device. Raters also evaluated critical tasks associated with device use. Mean error (ME) and mean percentage error (MPE) were used to assess predictive performance.Result: Among 486 infants enrolled (36.8 ± 4.0 weeks gestational age, 31.5 ± 28.6 days postnatal age), predicted weight correlated highly with actual weight (r = 0.97, ME: - 69 ± 257 g, MPE: - 1.3 ± 6.9%). Predicted weight was within 10 and 15% of actual weight in 86 and 99%, of infants. HF errors were low, 0.1-0.8% depending on task. In all cases raters were confident or very confident in their measurements.Conclusion: The device was statistically equivalent to the method on which it was based and approximated weight with acceptable variance from the true weight. HF data suggest the device is easy to use. This device can be used to estimate weight in infants when calibrated scales are impractical or unavailable. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Levator avulsion occurs in 10−35% of women after a first vaginal delivery, with forceps being the main risk factor. Three mechanisms have been proposed to account for the high risk of trauma: the additional space requirement, increased speed of distension, and/ or greater force. This study examines the additional space requirements associated with forceps to determine any associated increase in avulsion risk. Methods: This was an in vitro simulation study of spatial requirements for delivery of a fetal head by forceps, with mathematical modelling of spatial requirements using data from a local observational study. A balloon device was used to model head circumferences through the range of expected measurements at term, with measurements taken after application of three different types of forceps. Each measurement was performed in triplicate. Results: On average, forceps increased the circumference of the fetal head by 1.01 cm for Wrigley's, 1.04 cm for Kielland's, and 1.64 cm for Neville-Barnes forceps, resulting in an estimated increase in the diameter of the fetal head by 0.32 cm, 0.33 cm, and 0.52 cm, respectively. This increase was linear throughout the tested range. In 534 singleton pregnancies at term, we determined an odds ratio (OR) of 1.11 per centimeter head circumference for avulsion. Hence, the additional space requirement due to forceps explains ORs of 1.11, 1.12, and 1.19 for avulsion, depending on forceps type. Conclusions: The effect of forceps on avulsion risk is not fully explained by the increase in space requirement alone. Other factors, such as shortened time to maximum distension and/or increased peak force applied may contribute to the excess risk. [ABSTRACT FROM AUTHOR]

Background: Silymarin is a potent inhibitor of apoptosis. The present study aimed to investigate the effect of prenatal silymarin administration during the gestational period on fetal growth. Methods: This experimental study was conducted on 24 virgin female BALB/c mice weighing 20-30 grams. One male animal was caged with two females overnight, and they were examined for the presence of a vaginal plug in the next morning. Presence of vaginal plugs was considered to be gestational day zero (GD0). The mice were randomly divided into four groups, including three groups of pregnant mice administered with silymarin via intraperitoneal injection at doses of 50, 100, and 200 mg/kg/day (groups 1, 2, and 3, respectively) during GD6-15 (organogenesis) and a control group. Animals in the control group received normal saline via the same route in equivalent volumes. Data analysis was performed in SPSS version 18.0, and the pathological scores were compared using Kruskal-Wallis, ANOVA, and Dunn’s multiple comparison tests. P-value of less than 0.05 was considered statistically significant. Results: Administration of silymarin had no effect on the weight gain of the mothers. However, placental weight gain decreased in the second and third group compared to the other groups (P≤0.001). In addition, head circumference was observed to reduce in all the treatment groups compared to the control group (P≤0.001). Also, the findings showed significant differences in the resorption rate and weight gain in all the treatment groups compared to the control group (P=0.001). Conclusion: According to the results, silymarin administration during gestation may lower weight gain and decrease placental circumference in the fetus of mice.

Purpose: To determine if head circumference (HC) is an independent factor influencing second stage duration stratified by parity and epidural use.Materials and methods: A retrospective cohort analysis of all live, singleton, term (37-42 weeks) vaginal deliveries in one university affiliated medical center (2012-2014). Exclusion criteria included operative deliveries due to fetal distress, major fetal anomalies/chromosomal abnormalities or cases with missing anthropometric data. Maternal demographics, labor characteristics and neonatal anthropometrics including birth weight and HC were retrieved. Multivariate linear regression was utilized to evaluate the association between HC and second stage duration. Analysis was stratified into four groups by parity and epidural use.Results: Of the 16 240 singleton vaginal deliveries during study period, 12 428 deliveries met inclusion criteria. Stratification by parity and epidural analgesia yielded four groups: 3337 (26.9%), 735 (5.9%), 5099 (41.0%) and 3257 (26.2%) deliveries - nullipara with/without epidural and multipara with/without epidural, respectively. In all groups, a large neonatal HC was significantly and independently associated with longer second stage duration: nullipara with epidural (beta 10.06, 95% CI 7.75-12.37), nullipara without epidural (beta 7.58, 95% CI 4.73-10.43), multipara with epidural (beta 4.64, 95%CI 3.47-5.8) and multipara without epidural (beta 1.35, 95% CI 0.76-1.94), p < .001 for all. Birth weight was not associated with second stage duration in any of the groups (p > .05).Conclusion: Large neonatal HC is significantly associated with longer second stage duration. [ABSTRACT FROM AUTHOR]

Background and Objectives: Measuring head circumference (HC) of newborns is an important tool for evaluating intra-uterine brain development. HC reference charts currently in use in Nigeria are not representative of the local population. We thus present locally derived HC reference data for Nigerian infants at birth.Subjects and Methods: We reviewed birth records of all infants at the Jos University Teaching Hospital (JUTH) over a 10 year period from January 2006. JUTH is a tertiary care center offering obstetric services to a large population of women in Jos and its environs. All births with gestational age between 28 and 42 weeks were included in the study. STATA version 14 was used to calculate gestational age associated HC percentile measurements.Results: We included 18 282 babies to generate the reference values. The mean HC value was 34.4 ± 2.1 cm (M = 34.6 ± 2.16 cm, F = 34.1 ± 2.02 cm, p < 0.001). Our HC reference values significantly differ from the USA and INTERGROWTH-21 charts currently in use in our country. Mean HC was higher in male infants compared with female infants. This difference was uniformly so across all gestational age groups.Conclusions: The use of our locally derived HC reference values could be more appropriate in defining normal head growth in Nigerian infant populations thereby improving newborn care. [ABSTRACT FROM AUTHOR]