Developmental correlates of head circumference at birth and two years in a cohort of extremely low gestational age newborns.
OBJECTIVE
To evaluate the developmental correlates of microcephaly evident at birth and at 2 years in a cohort born at extremely low gestational age.


METHODS
We assessed development and motor function at 2 years of 958 children born before the 28th week of gestation, comparing those who had microcephaly at birth or 2 years with children with normal head circumference while considering the contribution of neonatal cranial ultrasound lesions.


RESULTS
A total of 11% of infants in our sample had microcephaly at 2 years. Microcephaly at 2 years, but not at birth, predicts severe motor and cognitive impairments at 2 years. A total of 71% of children with congenital microcephaly had a normal head circumference at 2 years and had neurodevelopmental outcomes comparable with those with normal head circumference at birth and 2 years. Among children with microcephaly at 2 years, more than half had a Mental Developmental Index <70, and nearly a third had cerebral palsy. The risks were increased if the child also had cerebral white matter damage on a cranial ultrasound scan obtained 2 years previously.


CONCLUSIONS
Among extremely low gestational age newborns, microcephaly at 2 years, but not at birth, is associated with motor and cognitive impairment at age 2.
Kuban
Karl C K
KC
Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, Boston, MA, USA. karl.kuban@bmc.org
Allred
Elizabeth N
EN
O'Shea
T Michael
TM
Paneth
Nigel
N
Westra
Sjirk
S
Miller
Cindy
C
Rosman
N Paul
NP
Leviton
Alan
A
D000367:Age Factors; D001921:Brain / Q000254:growth & development; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology*; D004453:Echoencephalography; D005865:Gestational Age; D006257:Head / Q000000981:diagnostic imaging / Q000254:growth & development; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008831:Microcephaly / Q000000981:diagnostic imaging / Q000453:epidemiology*; D019957:Motor Skills Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009929:Organ Size