55 HEAD CIRCUMFERENCE AT BIRTH AS A PREDICTOR OF NEUO-BEHAVIORAL OUTCOME

Abstract

Neurobehavioral (NB) outcome of low birth weight infants was studied in relation to head circumference (HC) at birth. Infants weighed ≤2250 gms. and/or were <than 37 weeks gestation (Dubowitz examination). Follow-up NB evaluation performed on 127 infants at the corrected chronologic age of 7 months consisted of a neurologic examination and administration of the Bayley Mental Scale (MDI). Ninety-one infants (71.7%) had appropriate HC for gestational age (AHA, <10th percentile, Lubchenko) and 35 (28.3%) had a small HC (SHA). MDI was <80 in 34.3% of SHA infants compared to only 16.3% of AHA infants (p<0.05). Severe neurologic deficit was found in 20% of SHA infants compared to only 5.5% of AHA infants (p<0.05). The incidences of MDI<80 and severe neurologic deficit in subgroups of AHA and SHA were not significantly affected by whether total body weight was appropriate or small for gestational age (AGA or SGA). Thus: Previously reported associations of fetal body growth retardation with poor NB outcome probably apply primarily in those infants with fetal head growth retardation (SHA). Evaluation of HC at birth in relation to gestational age adds an important dimension to the prediction of neurologic outcome.