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The size of the human head is highly heritable, but genetic drivers of its variation within the general population remain unmapped. We perform a genome-wide association study on head size (N = 80,890) and identify 67 genetic loci, of which 50 are novel. Neuroimaging studies show that 17 variants affect specific brain areas, but most have widespread effects. Gene set enrichment is observed for various cancers and the p53, Wnt, and ErbB signaling pathways. Genes harboring lead variants are enriched for macrocephaly syndrome genes (37-fold) and high-fidelity cancer genes (9-fold), which is not seen for human height variants. Head size variants are also near genes preferentially expressed in intermediate progenitor cells, neural cells linked to evolutionary brain expansion. Our results indicate that genes regulating early brain and cranial growth incline to neoplasia later in life, irrespective of height. This warrants investigation of clinical implications of the link between head size and cancer.

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

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

Background: Prenatal ethylene oxide exposure may have adverse effects on fetal development. We examined the relationships between ethylene oxide hemoglobin (Hb) adduct levels and offspring's size at birth in a prospective European mother--child study. Methods: This study included 1106 singletons from the NewGeneris project (2006-2010) with ethylene oxide Hb adducts measured in cord blood. We examined the relationships between adduct levels and offspring's size at birth among all infants and separately among infants of nonsmokers, using linear regression models for birth weight and birth head circumference and logarithmic binomial regression models for small for gestational age. We examined potential interactions between CYP2E1 single nucleotide polymorphisms in cord blood and the effects of ethylene oxide Hb adduct levels on offspring birth size. Results: Higher quartiles of adduct levels as a measure of exposure were associated with decreasing birth weight and head circumference in the overall population. Compared to infants in the lowest quartile, those in the highest quartile exhibited lower birth weight (-70.73 g, 95% confidence interval = -141.16, -0.30) and reduced head circumference (-0.30 cm, 95% confidence interval = -0.58, -0.02). We observed similar, albeit less pronounced, patterns among infants of nonsmokers. There was no evidence of an association between ethylene oxide Hb adducts and risk of small for gestational age, nor consistent evidence of an interaction with CYP2E1 polymorphisms on the association between EO Hb adduct levels and offspring's size at birth. Conclusion: Results suggest that higher ethylene oxide Hb adduct levels in cord blood are associated with a reduction in offspring birth size. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the growth trajectory of head circumference and neurodevelopment, and to correlate head circumference with cognitive, language, and motor outcomes during the first two years. Method: Prospective cohort study in a tertiary hospital including 95 newborns under 32 weeks or 1500 g. Neonates who developed major neonatal morbidities were excluded. The head circumference was measured at birth, at discharge, and at term-equivalent age, 1, 3, 5, 12, 18, and 24 months of corrected age, and the Bayley Scales (Bayley-III) were applied at 12, 18 and 24 months of corrected age to assess cognitive, language and, motor domains. Scores below 85 were classified as mild/moderate deficits and scores below 70 as severe deficits. The association between head circumference Z score and Bayley scores was assessed using Pearson’s correlation. The study considered a significance level of 0.05. Results: There was a decrease of -0.18 in the head circumference Z score between birth and discharge and the catch-up occurred between discharge and 1 month (an increase of 0.81 in the Z score). There was a positive correlation between head circumference and Bayley scores at 18 months. There was also a positive correlation between head circumference at discharge and at 5 months with the three domains of the Bayley. [ABSTRACT FROM AUTHOR]

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

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

Background: Macrocephaly is described in almost 15% of children with Autism Spectrum Disorder (ASD). Relationships between head growth trajectories and clinical findings in ASD children show a high degree of variability, highlighting the complex heterogeneity of the disorder. Objectives: The aim of this study was to measure differences of the early growth trajectory of head circumference (HC) in children with ASD and macrocephaly compared to ASD normocephalic children, examining clinical correlates in the two groups of patients. Methods: HC data were collected from birth to 5 years of age in a sample of children with a confirmed diagnosis of ASD. Participants were classified into two groups: ASD macrocephaly (ASD-M, Z-scores =1.88 in at least two consecutive HC measurements), and ASD non-macrocephaly (ASD-N). Based on the distribution of HC measurements (Z-scores), five age groups were identified for the longitudinal study. Developmental and behavioral characteristics of the ASD-M children compared to the ASD-N group were compared by using standardized scores. Results: 20,8% of the children sample met criteria for macrocephaly. HC values became indicative of macrocephaly in the ASD-M group at the age range from 1 to 6 months, and persisted thereafter throughout the first five years of age. ASDM children showed significantly higher developmental quotients of Griffiths III B and D subscales compared to ASD-N group. No significant differences in the severity of ASD symptoms assessed by ADOS-2 were observed between ASD-M and ASD-N groups. Conclusion: In this study HC size from birth to 5 years links to accelerated HC growth rate as early as the first 6 months of age in children with ASD and macrocephaly, preceding the onset and diagnosis of ASD. We found that in early childhood, children with ASD-M may exhibit some advantages in language and social communication and emotional skills without differences in autism severity, when compared with age-matched normocephalic ASD children. Longitudinal analyses are required to catch-up prospectively possible relationships between head size as proxy measure of brain development and neuro-developmental and behavioral features in children with ASD. [ABSTRACT FROM AUTHOR]

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

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

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

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Objective: To evaluate the growth trajectory of head circumference and neurodevelopment, and to correlate head circumference with cognitive, language, and motor outcomes during the first two years. Method: Prospective cohort study in a tertiary hospital including 95 newborns under 32 weeks or 1500 g. Neonates who developed major neonatal morbidities were excluded. The head circumference was measured at birth, at discharge, and at term-equivalent age, 1, 3, 5, 12, 18, and 24 months of corrected age, and the Bayley Scales (Bayley-III) were applied at 12, 18 and 24 months of corrected age to assess cognitive, language and, motor domains. Scores below 85 were classified as mild/moderate deficits and scores below 70 as severe deficits. The association between head circumference Z score and Bayley scores was assessed using Pearson's correlation. The study considered a significance level of 0.05. Results: There was a decrease of -0.18 in the head circumference Z score between birth and discharge and the catch-up occurred between discharge and 1 month (an increase of 0.81 in the Z score). There was a positive correlation between head circumference and Bayley scores at 18 months. There was also a positive correlation between head circumference at discharge and at 5 months with the three domains of the Bayley. Conclusion: Serial measurements of head circumference provide knowledge of the trajectory of growth, with early catch-up between discharge and 1 month, as well as its association with neurodevelopment. Head circumference is therefore a valuable clinical marker for neurodevelopment, especially in very preterm newborns.

Objectives: To determine the association between HIV infection and anthropometric measures (weight, height, midupper arm circumference and head circumference) of children aged one to five years. Method: A cross sectional descriptive study using structured questionnaire and measurement of weight, height, head and midupper arm circumference of 846 infected children and matched controls. Results: The mean weights of the controls were significantly higher than those of the infected children at all age groups (p

Background: Anthropometric parameters such as body weight, body length, occipitofrontal circumference and foot length are known to increase with gestational age. The estimated gestational age (EGA) is the approximate duration of pregnancy to the nearest two weeks at the point of birth. Objective: To determine if there is a relationship between postnatal foot length and anthropometric parameters such as body weight, body length and occipito-frontal circumference in the estimation of gestational age among Nigerian neonates. Methods: At the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, a cross-sectional study was carried out among 260 neonates with EGA 30- 42 weeks within the first 48 hours of life between December 2017 and December 2019. Postnatal foot lengths were measured with Vernier digital caliper while body weight, body length and occipitofrontal circumference (OFC) were also measured using standard procedures. CC –BY 4.0 Results: The postnatal foot length, body weight, body length and occipitofrontal circumference showed steady rise with increasing estimated gestational age. The boy weight ranged from 1.19± 0.14kg at 30 weeks to 3.41±0.44 at 42 weeks. The range of body length was 37.78±2.58cm at 30weeks to 50.60±1.67cm at 42 weeks. The occipitofrontal circumference also ranged from 26.65±1.47cmat 30 weeks to 35.40±1.63cm at 42 weeks. The foot length had strong correlation with the body weight (r= 0.892), body length (r = 0.754) and OFC (r = 0.801) in the preterm neonates. In the term neonates, the foot length had moderate correlations with each of the three parameters (r = 0.632, r = 0.473and r = 0.496). Conclusion: Postnatal foot length had the highest correlation with body weight among preterm and term neonates hence, it will be a useful proxy for birth weight in the estimation of gestational age among Nigerian neonates.

Monitoring fetal growth in utero is crucial to anomaly diagnosis. However, current computer-vision models struggle to accurately assess the key metrics (i.e., head circumference and occipitofrontal and biparietal diameters) from ultrasound images, largely owing to a lack of training data. Mitigation usually entails image augmentation (e.g., flipping, rotating, scaling, and translating). Nevertheless, the accuracy of our task remains insufficient. Hence, we offer a U-Net fetal head measurement tool that leverages a hybrid Dice and binary cross-entropy loss to compute the similarity between actual and predicted segmented regions. Ellipse-fitted two-dimensional ultrasound images acquired from the HC18 dataset are input, and their lower feature layers are reused for efficiency. During regression, a novel region of interest pooling layer extracts elliptical feature maps, and during segmentation, feature pyramids fuse fieldlayer data with a new scale attention method to reduce noise. Performance is measured by Dice similarity, mean pixel accuracy, and mean intersectionover- union, giving 97.90%, 99.18%, and 97.81% scores, respectively, which match or outperform the best U-Net models.

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

Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown–heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28–42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown–heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, −0.008; 95% CI, −0.011–−0.004; p < 0.001) and head circumference (β coefficient, −0.004; 95% CI, −0.007–−0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown–heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation. [ABSTRACT FROM AUTHOR]

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

Monitoring fetal growth in utero is crucial to anomaly diagnosis. However, current computer‐vision models struggle to accurately assess the key metrics (i.e., head circumference and occipitofrontal and biparietal diameters) from ultrasound images, largely owing to a lack of training data. Mitigation usually entails image augmentation (e.g., flipping, rotating, scaling, and translating). Nevertheless, the accuracy of our task remains insufficient. Hence, we offer a U‐Net fetal head measurement tool that leverages a hybrid Dice and binary cross‐entropy loss to compute the similarity between actual and predicted segmented regions. Ellipse‐fitted two‐dimensional ultrasound images acquired from the HC18 dataset are input, and their lower feature layers are reused for efficiency. During regression, a novel region of interest pooling layer extracts elliptical feature maps, and during segmentation, feature pyramids fuse field‐layer data with a new scale attention method to reduce noise. Performance is measured by Dice similarity, mean pixel accuracy, and mean intersection‐over‐union, giving 97.90%, 99.18%, and 97.81% scores, respectively, which match or outperform the best U‐Net models. [ABSTRACT FROM AUTHOR]

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

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

• Significant results were found on days 20 and 30 in height and weight increases of preterm infants who received massage. • Significant results were found on days 5, 10, 20 and 30 in head circumference of preterm infants who received massage. • It was found that preterm infants who received massage had better amount of feeding, and this increased weight intake and reduced discharge time. • It was found that preterm infants who received massage were discharged 10 days earlier on average. This will reduce the amount of cost per infant in the hospital. • The present research is the first research in literature in which massage was applied 30 min a day, 15 in the morning and 15 in the evening, for a month and which was followed for a month. 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. This research was conducted to determine the effects of massage on the development of preterm infants. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Aim: In this study, we compared the ratio of second trimester fetal biometric measurements to nasal bone length (NBL) in fetuses with normal karyotype and trisomy 21 to determine their diagnostic prognostic value. Materials and Methods: The study included 148 pregnant women who obtained second‐trimester ultrasonographic fetal anatomy and had amniocentesis (AS) for fetal karyotyping. The fetal karyotype results divided the groups into normal and trisomy 21 fetuses. Age, obstetric history, first and/or second trimester screening test risk ratios, fetal biometric measurements, and NBL mm, median (MoM) multiples, and percentile values were recorded and compared between groups. Results: BPD/NBL ratios above 9.26 predict trisomy 21 in fetuses with 77.6% sensitivity and 86.1% specificity (p = 0.001). HC/NBL ratios above 34.50 predict trisomy 21 in fetuses with 77.8% sensitivity and 88.8% specificity (p = 0.001). FL/NBL ratios above 6.02 predict trisomy 21 in fetuses with 69.6% sensitivity and 72.2% specificity (p = 0.001). HL/NB ratios above 6.56 predict trisomy 21 in fetuses with 95.5% sensitivity and 47.2% specificity (p = 0.001). The NBL MoM value demonstrated a high diagnostic accuracy for normal‐karyotype fetuses (p = 0.021). Conclusion: We found that BPD/NBL, HC/NBL, FL/NBL, and HL/NBL ratios differed between fetuses with a normal karyotype and those with trisomy 21, specifically the HC/NBL ratio, which predicted trisomy 21 with good diagnostic accuracy. In identifying normal‐karyotype fetuses, the NBL MoM was highly accurate. [ABSTRACT FROM AUTHOR]

Subtle changes in body temperature affect the outcomes of ill newborns. However, the temperature profile of neonatal brains remains largely unknown. In open-cot care, increased cerebral perfusion is correlated with higher superficial brain temperatures. This study investigated the dependence of brain temperature (relative to rectal temperature) on ambient temperature, body size, cerebral perfusion, and metabolism in infants receiving incubator care. Rectal, scalp, and brain temperatures, superior vena cava flow, and brain oxygenation were assessed using echocardiography, thermo-compensatory temperature monitoring, and near-infrared spectroscopy in 60 newborns. These infants had a mean postconceptional age of 36.9 (2.2) weeks and weighed 2348 (609) g at the time of evaluation. The ambient temperature was maintained at 30.0 (1.0) °C. A higher rectal temperature was associated with greater postconceptional age (p = 0.002), body weight (p < 0.001), and head circumference (p < 0.001). Relative scalp, superficial brain, and deep brain temperatures were associated with smaller head circumference (p < 0.001, p = 0.030, and p = 0.015, respectively) and superior vena cava flow (p = 0.002, p = 0.003, and p = 0.003, respectively). In infants receiving incubator care, larger head sizes and increased brain perfusion were associated with lower relative scalp and brain temperatures. When considered alongside previous reports, cerebral perfusion may contribute to maintaining stable cerebral tissue temperature against ambient temperature changes. [ABSTRACT FROM AUTHOR]

BackgroundMacrocephaly is described in almost 15% of children with Autism Spectrum Disorder (ASD). Relationships between head growth trajectories and clinical findings in ASD children show a high degree of variability, highlighting the complex heterogeneity of the disorder.ObjectivesThe aim of this study was to measure differences of the early growth trajectory of head circumference (HC) in children with ASD and macrocephaly compared to ASD normocephalic children, examining clinical correlates in the two groups of patients.MethodsHC data were collected from birth to 5 years of age in a sample of children with a confirmed diagnosis of ASD. Participants were classified into two groups: ASD macrocephaly (ASD-M, Z-scores ≥1.88 in at least two consecutive HC measurements), and ASD non-macrocephaly (ASD-N). Based on the distribution of HC measurements (Z-scores), five age groups were identified for the longitudinal study. Developmental and behavioral characteristics of the ASD-M children compared to the ASD-N group were compared by using standardized scores.Results20,8% of the children sample met criteria for macrocephaly. HC values became indicative of macrocephaly in the ASD-M group at the age range from 1 to 6 months, and persisted thereafter throughout the first five years of age. ASD-M children showed significantly higher developmental quotients of Griffiths III B and D subscales compared to ASD-N group. No significant differences in the severity of ASD symptoms assessed by ADOS-2 were observed between ASD-M and ASD-N groups.ConclusionIn this study HC size from birth to 5 years links to accelerated HC growth rate as early as the first 6 months of age in children with ASD and macrocephaly, preceding the onset and diagnosis of ASD. We found that in early childhood, children with ASD-M may exhibit some advantages in language and social communication and emotional skills without differences in autism severity, when compared with age-matched normocephalic ASD children. Longitudinal analyses are required to catch-up prospectively possible relationships between head size as proxy measure of brain development and neuro-developmental and behavioral features in children with ASD.

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

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

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

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

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

Infant anthropometry is an indicator of neonatal survival. This study aimed to determine the effects of maternal anthropometry on estimating infant anthropometry. This cross-sectional study on 173 pregnant women at Public Hospital X in Ternate, Indonesia, was conducted from August 2018 to March 2023. The eligible criteria were pregnant women aged =18 years, single pregnancy, and antenatal care (ANC) visits to the same hospital. The variables used included maternal anthropometric measurements (body weight, body height, third-trimester weight (TTW)), gestational weight gain (GWG), education, age, ANC visits, and gestational age at delivery (GAD). A logistic regression model was employed to estimate significant variables related to infant anthropometric measurements (birth weight, birth length, and head circumference). The results showed that TTW, GWG, ANC, and GAD had significantly affected birth weight. Body weight, height, and TTW also significantly affected birth length. In addition, only GAD significantly affected the head circumference. In multivariate analysis, TTW and GWG significantly affected birth weight. Furthermore, only body height and GAD affected the birth length. Maternal anthropometrics become important indicators for estimating birth weight and birth length. [ABSTRACT FROM AUTHOR]

Hypochondroplasia (HCH) is a rare skeletal dysplasia causing mild short stature. There is a paucity of growth reference charts for this population. Anthropometric data were collected to generate height, weight, and head circumference (HC) growth reference charts for children with a diagnosis of HCH. Mixed longitudinal anthropometric data and genetic analysis results were collected from 14 European specialized skeletal dysplasia centers. Growth charts were generated using Generalized Additive Models for Location, Scale, and Shape. Measurements for height (983), weight (896), and HC (389) were collected from 188 (79 female) children with a diagnosis of HCH aged 0–18 years. Of the 84 children who underwent genetic testing, a pathogenic variant in FGFR3 was identified in 92% (77). The data were used to generate growth references for height, weight, and HC, plotted as charts with seven centiles from 2nd to 98th, for ages 0–4 and 0–16 years. HCH‐specific growth charts are important in the clinical care of these children. They help to identify if other comorbidities are present that affect growth and development and serve as an important benchmark for any prospective interventional research studies and trials. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

IntroductionHuman 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.MethodsData 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.ResultsSecular 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).DiscussionThe different patterns of changes in physical growth, biological maturation, and intelligence between 1978 and 1993 indicate that distinct mechanisms underlie these secular trends.

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

Abstract Backgrounds The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants. Methods PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review. Results Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality. Conclusions The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD.

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

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

Periconceptional maternal ultra-processed food (UPF) consumption impairs embryonic growth. Impacts of exposure to UPF on distinct components of fetal growth in late pregnancy are unknown. We investigated the influence of frequency of UPF consumption during pregnancy on fetal head circumference (HC), abdominal circumference (AC) and femur length (FL). This study included 417 live-born singleton pregnancies prospectively followed-up since the antenatal period in the MINA-Brazil Study, with an available ultrasound scan at >24 gestational weeks. Frequency of food groups consumption in the previous month was categorised as no/monthly, weekly or daily. Ultrasound scans were conducted at 27·8 (sd: 1·7) gestational weeks. HC, AC and FL z-scores were calculated for gestational age using the INTERGROWTH-21st Project standards. Simultaneous-quantile regression models were fitted at the 10th, 50th and 90th percentiles of the distribution of each ultrasound parameter according to UPF consumption, with adjustment for potential confounders. Participants were aged on average 24·7 (sd: 6·5) years, 44·8 % were primiparous, and 26·9 % and 24·9 %, respectively, had weekly and daily UPF consumption. Compared with no/monthly intake, daily UPF consumption impaired HC across its distribution, with significant effect sizes varying from –0·24 to –0·40 z-score. Weekly UPF consumption decreased HC at the 90th percentile by –0·39 z-score (95 % CI: –0·78, –0·01) and FL at the 50th percentile by –0·32 z-score (95 % CI: –0·60, –0·04). No association was noted with AC. Frequency of UPF consumption was negatively associated with skeletal components of fetal growth in late pregnancy. Infant body composition may benefit from healthy food practices since pregnancy. [ABSTRACT FROM AUTHOR]

Backgrounds: The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants. Methods: PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review. Results: Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality. Conclusions: The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD. [ABSTRACT FROM AUTHOR]

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

During pregnancy, it is considered to be necessary to monitor and measure fetal development. There are different fetal biometrics among which the fetal head biometrics are useful for finding out the fetus age, diagnosing malformations, and lowering the fetal mortality rate. Accurate measurement of fetal biometry is difficult because of a variety of factors such as the ultrasound image's low quality, inter-and intra-observer variability, and human error as a result of manual estimation. As a result of these issues, new-born babies are born with defects. To track and test fetal head biometrics, several automated and semi-automated methods have been proposed. However, most of the techniques are inaccurate, and the procedure is time-consuming. This work presents the creation of a new process for the segmentation of two-dimensional ultrasound images of fetal skulls based on convolution neural network combination U-Net architecture (UNet-C) and finding the circumference of the fetal head using the Midpoint ellipse drawing algorithm. A new strategy is developed based on U-Net for pre-processing, drop-out, evaluation of different activation layers, activation function, data augmentation, loss function and depth of the network. The computational results reveal the feasibility of the proposal in the correct segmentation of fetal skulls and head circumference measurements and achieved an accuracy of 98.55%. Validation loss and overall loss is calculated to be 0.287 and 0.0390. Validation accuracy and overall accuracy is calculated to be 0.9891 and 0.9840. The mean difference of the proposed method is between − 1.68 and 1.10 and the mean absolute difference is − 1.5 to 0.97. The proposed method is used to detect fetal head and measure circumference of head (HC), bi-parietal diameter (BPD) and occipito frontal diameter (OFD) of a fetus. [ABSTRACT FROM AUTHOR]