Head Circumference Measurements Research Articles

Megalencephaly: Classification, Genetic Causes, and Related Syndromes

AbstractMegalencephaly is a developmental disorder due to an abnormal neuronal proliferation and migration during intrauterine or postnatal brain development that leads to cerebral overgrowth and neurological dysfunction. This cerebral overgrowth may affect the whole encephalon or only a region; when it involves one hemisphere it is referred to as hemimegalencephaly. Megalencephaly presents with a head circumference measurement of 2 standard deviations above the average measure for age. This group of disorders is clinically characterized by early onset and refractory to therapy epilepsy, neurodevelopmental disorders, behavioral problems, and autism spectrum disorder. Syndromic forms of megalencephaly should be considered when associated with other congenital abnormalities. Megalencephaly in fact could be associated with segmental overgrowth and cutaneous/vascular abnormalities (i.e., Proteus syndrome, CLOVES [congenital lipomatous overgrowth, vascular malformations, epidermal naevi, scoliosis, and/ or skeletal abnormalities] syndrome, Klippel-Trenaunay syndrome, megalencephaly-capillary malformation-polymicrogyria syndrome , megalencephaly-postaxial polydactyly-polymicrogyria-hydrocephalus syndrome, etc.) or generalized overgrowth (i.e., Weaver or Beckwith-Wiedemann syndrome) as well as with nanism in achondroplasia where megalencephaly is associated with disproportionate short stature, primary skeletal dysplasia, characteristic facies (prominent forehead, flat nasal bridge), narrow chest, and normal intelligence. It is possible to identify three main groups of disorders associated with megalencephaly: idiopathic or benign, metabolic, and anatomic. The idiopathic (benign) form indicates an abnormal increased head circumference in absence of neurological impairment, such as in benign familial megalencephaly. In metabolic megalencephaly (such as in organic acid disorders, metabolic leukoencephalopathies, or lysosomal diseases) there is an increase of different constituents that increase the size of the brain, whereas in the anatomical form there are underlying genetic causes. Neuroimaging is crucial for diagnosis, as it can reveal a generalized brain growth or a segmental one and possible specific frameworks associated. In all these conditions it is necessary to identify possible microdeletion-microduplication by chromosomal arrays.

Fetal and Infancy Exposure to Phenols, Parabens, and Phthalates and Anthropometric Measurements up to 36 Months, in the Longitudinal SEPAGES Cohort.

Endocrine-disrupting chemicals may play a role in adiposity development during childhood. Until now literature in this scope suffers from methodologic limitations in exposure assessment using one or few urine samples and missing assessment during the infancy period. We investigated the associations between early-life exposure to quickly metabolized chemicals and post-natal growth, relying on repeated within-subject urine collections over pregnancy and infancy. We studied the associations of four phenols, four parabens, seven phthalates, and one nonphthalate plasticizer from weekly pooled urine samples collected from the mother during second and third trimesters (median 18 and 34 gestational weeks, respectively) and infant at 2 and 12 months of age, and child growth until 36 months. We relied on repeated measures of height, weight and head circumference from study visits and the child health booklet to predict growth outcomes at 3 and 36 months using the Jenss-Bayley nonlinear mixed model. We assessed associations with individual chemicals using adjusted linear regression and mixtures of chemicals using a Bayesian kernel machine regression model. The unipollutant analysis revealed few associations. Bisphenol S (BPS) at second trimester was positively associated with all infant growth parameters at 3 and 36 months, with similar patterns between exposure at third trimester and all infant growth parameters at 3 months. Mono-n-butyl phthalate (MnBP) at 12 months was positively associated with body mass index (BMI), weight, and head circumference at 36 months. Mixture analysis revealed positive associations between exposure at 12 months and BMI and weight at 36 months, with MnBP showing the highest effect size within the mixture. This study suggests that exposure in early infancy may be associated with increased weight and BMI in early childhood, which are risk factors of obesity in later life. Furthermore, this study highlighted the impact of BPS, a compound replacing bisphenol A, which has never been studied in this context. https://doi.org/10.1289/EHP13644.

Correlation of Stature with Head Circumference of Male Adults of Upper Punjab

Objective: This study aimed to find how head circumference and stature related to males in Upper Punjab between the ages of 21 and 30. Material and Method: The investigation was conducted using a quantitative methodology. The 382 adult male residents of Kharian City provided the data. The program SPSS 25 was used to conduct the analysis. Results: The average stature, as determined by descriptive data, was 170.4 cm. 56.45 cm was the average head circumference. The height and head circumference have a 0.518 Pearson correlation. The value of r shows a statistically significant positive correlation. After the regression analysis was completed, the regression equation was used to label the regression curve. Conclusion: The results of this investigation showed a correlation between head circumference and stature. Measuring head circumference will help forensic experts determine stature, especially when only the head is exposed due to a natural or artificial calamity

The relationship between anterior fontanelle and head circumference in term newborns

Aims: At birth, infants have membranous cavities called fontanelles because the angles of the skull bones have not yet formed. Its size is generally accepted as an indicator of cranial development and bone maturation. Head circumference measurement is an important marker for predicting brain development, especially in early childhood. Methods: Patients followed up in the pediatric outpatient clinic of Kırşehir Training and Research Hospital between January 2020 and January 2024 were retrospectively analyzed. Anterior fontanelle width and head circumference measurements of babies born on the day recorded in the system were recorded. Results: A total of 340 (M/F: 188/152) patients were included in the study. There was a positive correlation between fontanel width and head circumference at birth, at 1 month and at 2 months (p<0.05). There was no correlation between fontanel width and head circumference at 3,4,6, 9, 12 months (p>0.05). Conclusion: A significant relationship was found between anterior fontanelle width and head circumference in the first months of life. It is considered to be taken into consideration in the follow-up of healthy children. However, further studies are needed in this context and our study will contribute to future studies.

Head growth in patients with myelomeningocele treated with prenatal and postnatal surgery.

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. 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. 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). 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.

Incidence of neonatal morbidity in small-for-gestational-age twins based on singleton and twin charts.

To compare morbidity, as measured by length of stay in the neonatal intensive care unit (NICU), in twin and singleton gestations classified as small-for-gestational age (SGA) according to estimated fetal weight < 10th percentile on twin or singleton growth charts. NICU length of stay was compared in 1150 twins and 29 035 singletons that underwent ultrasound assessment between 35 + 0 and 36 + 6 weeks' gestation. Estimated fetal weight was obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Gestational age was derived from the first-trimester crown-rump length measurement, using the larger of the two twins. Singletons and twins were compared in terms of NICU admission rate and length of stay according to classification as SGA by the Fetal Medicine Foundation singleton and twin reference distributions. The overall proportions of twins and singletons admitted to NICU were similar (7.3% vs 7.4%), but twins tended to have longer lengths of stay in NICU (≥ 7 days: 2.4% vs 0.8%; relative risk (RR), 3.0 (95% CI, 1.6-4.4)). Using the singleton chart, a higher proportion of twins were classified as SGA compared with singletons (37.6% vs 7.0%). However, the proportion of SGA neonates entering NICU was similar (10.2% for twins and 10.1% for singletons) and the proportion of SGA neonates spending ≥ 7 days in NICU was substantially higher for twins compared with singletons (3.7% vs 1.4%; RR, 2.6 (95% CI, 1.4-4.7)). When singleton charts are used to define SGA in twins and in singletons, there is a greater degree of growth-related neonatal morbidity amongst SGA twins compared with SGA singletons. Consequently, singleton charts do not inappropriately overdiagnose fetal growth restriction in twins and they should be used for monitoring fetal growth in both twins and singletons. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Fetal Biometric Parameter Reference Charts of a Central Anatolian Turkish Population.

The assessment of fetal biometry using ultrasound provides accurate pregnancy dating and also screening of fetal growth. Fetal biometry, which is common practice in the second and third trimesters of pregnancy, is fetal morphometry, which involves taking measurements of the different anatomical body parts. These fetal dimensions vary on ethnicity. The aim of this study is to demonstrate fetal biometric parameters measurement results of the Central Anatolia Turkish population with detailed percentile tables and graphs to screen fetal growth more accurately. This cross-sectional study was performed on a total of 1132 fetuses (47% girl, and 53% boy) between 15 and 40 weeks of gestation. Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) measurements are performed in a standardized manner every gestational week. BPD and HC were measured at the level of the thalami on the horizontal plane of the fetal head. HC was measured using the ellipse method. AC measurement was taken at the circular cross-section of the upper fetal abdomen. FL was measured along with the ossified diaphysis of the femur. All measurements were taken in millimeters. Pregnant women's mean age was 27.58 (17-43), and the mean body mass index was 27.68 (15.06-50.78) as demographic data. 38.13% of women had their first, 29.74% had their second, and 32.13% had three or more gestations within our study. Percentile data of fetuses for each parameter (BPD, HC, AC, and FL) and for each week were shown as tables and percentile graphics. Fetal 50th percentile measurements were compared between our study and other studies from different countries. The Kruskal-Wallis test results showed that BPD (p = 0.827), HC (p = 0.808), AC (p = 0.846), and FL (p = 0.725) values have a statistically similar mean in all studies. Hierarchical cluster analysis results showed that our results for BPD, HC, AC, and FL percentile curves have been found closer to Italian population results. However, our results were statistically different from Asian, Nigerian, non-Hispanic American, and Brazilian populations for each of the different parameters. The specialization of fetal biometric charts for a particular population can ensure a more accurate assessment of fetal growth rate. We showed fetal biometric percentile tables and graphics of the Central Anatolian Turkish population in this study. These results may provide a valuable contribution to obstetrical practice.Further studies can be conducted in different regions of Turkiye, thus comparisons could be possible over the country.

Fetal brain growth and infant autistic traits

BackgroundStructural differences exist in the brains of autistic individuals. To date only a few studies have explored the relationship between fetal brain growth and later infant autistic traits, and some have used fetal head circumference (HC) as a proxy for brain development. These findings have been inconsistent. Here we investigate whether fetal subregional brain measurements correlate with autistic traits in toddlers.MethodsA total of 219 singleton pregnancies (104 males and 115 females) were recruited at the Rosie Hospital, Cambridge, UK. 2D ultrasound was performed at 12-, 20- and between 26 and 30 weeks of pregnancy, measuring head circumference (HC), ventricular atrium (VA) and transcerebellar diameter (TCD). A total of 179 infants were followed up at 18–20 months of age and completed the quantitative checklist for autism in toddlers (Q-CHAT) to measure autistic traits.ResultsQ-CHAT scores at 18–20 months of age were positively associated with TCD size at 20 weeks and with HC at 28 weeks, in univariate analyses, and in multiple regression models which controlled for sex, maternal age and birth weight.LimitationsDue to the nature and location of the study, ascertainment bias could also have contributed to the recruitment of volunteer mothers with a higher than typical range of autistic traits and/or with a significant interest in the neurodevelopment of their children.ConclusionPrenatal brain growth is associated with toddler autistic traits and this can be ascertained via ultrasound starting at 20 weeks gestation.

Birth weight and head circumference discordance and outcome in preterms: results from the EPIPAGE-2 cohort

ObjectiveTo determine whether the relative measurement of birth weight (BW) and head circumference (HC) in preterm infants is associated with neurological outcomes.MethodsThe EPIPAGE-2 Study included 3473 infants born before 32...

Measurement of Head Circumference Using a Smartphone: Feasibility Cohort Study.

Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to errors, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner techniques, including tape measure placement and tautness. There is, therefore, the need for a more reliable method. The primary objective of this study was to evaluate the validity, reliability, and consistency of HC app measurement compared to the current standard of practice, serving as a proof-of-concept for use by health care professionals. We recruited infants attending the neurosurgery clinic, and parents/guardians were approached and consented to participate in the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app (HC app) developed in-house, and we also collected baseline medical history and characteristics. For the statistical analysis, we used RStudio (version 4.1.1). In summary, we analyzed covariance and intraclass correlation coefficient (ICC) to compare the measurement's within-rater and interrater reliability. The F test was used to analyze the variance between measurements and the Bland-Altman agreement, t test, and correlation coefficients were used to compare the tape measurement to the measures taken by the HC app. We also used nonvalidated questionnaires to explore parental or guardians' experiences, assess their views on app utility, and collect feedback. The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability (ICC=0.177) and wide within-app variations (ICC=0.341). The agreement between the measurements done by parents/guardians and the tape measurements done by the researcher was good (ICC=0.901). Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (n=31, 84%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality. We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by parents/guardians in their own homes.

The investigation of serum phenylalanine levels based on infant feeding method: a cross-sectional study of children less than two years old with phenylketonuria (PKU)

BackgroundClinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran.MethodsWe conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study.ResultsOf 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1–3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4–24 mg/dL [0.22–1.33 μmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5–37 mg/dL [0.27–2.05 μmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1–7 mg/dL [0.05–0.38 μmol/L] and mean 4.89, SD 3.68; range 2–19 mg/dL [0.11–1.05 μmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment.ConclusionsIn conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria.

Fetal Medicine Foundation charts for fetal growth in twins.

To derive reference distributions of estimated fetal weight (EFW) in twins relative to singletons. Gestational-age- and chorionicity-specific reference distributions for singleton percentiles and EFW were fitted to data on 4391 twin pregnancies with two liveborn fetuses from four European centers, including 3323 dichorionic (DC) and 1068 monochorionic diamniotic (MCDA) twin pregnancies. Gestational age was derived using the larger of the two crown-rump length measurements obtained during the first trimester of pregnancy. EFW was obtained from ultrasound measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Singleton percentiles were obtained using the Fetal Medicine Foundation population weight charts for singleton pregnancies. Hierarchical models were fitted to singleton Z-scores with autoregressive terms for serial correlations within the same fetus and between twins from the same pregnancy. Separate models were fitted for DC and MCDA twins. Fetuses from twin pregnancies tended to be smaller than singletons at the earliest gestational ages (16 weeks for MCDA and 20 weeks for DC twins). This was followed by a period of catch-up growth until around 24 weeks. After that, both DC and MCDA twins showed reduced growth. In DC twins, the EFW corresponding to the 50th percentile was at the 50th percentile of singleton pregnancies at 23 weeks, the 43rd percentile at 28 weeks, the 32nd percentile at 32 weeks and the 22nd percentile at 36 weeks. In MCDA twins, the EFW corresponding to the 50th percentile was at the 36th percentile of singleton pregnancies at 24 weeks, the 29th percentile at 28 weeks, the 19th percentile at 32 weeks and the 12th percentile at 36 weeks. In DC and, to a greater extent, MCDA twin pregnancies, fetal growth is reduced compared with that observed in singleton pregnancies. Furthermore, after 24 weeks, the divergence in growth trajectories between twin and singleton pregnancies becomes more pronounced as gestational age increases. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Head Circumference Measurements Based on Nutritional Status of Hospitalized Children

Head Circumference Measurements Based on Nutritional Status of Hospitalized Children

Crecimiento y desarrollo puberal en niñas adoptadas de Rusia: seguimiento de 12 años

Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.

Autism Spectrum Disorder and Head Circumference in children under 5 years of age attending a public clinic in Johannesburg, South Africa

Abstract Introduction: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that is increasing in prevalence globally. There is an emerging field of research investigating the association between head circumference and ASD but there is a marked paucity of such data from Southern Africa. Aim: To describe the head circumference (HC) measurement of children diagnosed with ASD and to investigate associations between HC, ASD severity levels and associated comorbidities. Methods: A retrospective record review of children diagnosed with ASD attending a neurodevelopmental clinic at a large public hospital in South Africa was conducted. Demographic data and HC measurements from the first clinic visit were collected. The World Health Organization data set of head circumference norms were used as the comparator reference population. Statistical analysis was conducted using parametric, descriptive and inferential methods. Results: Data from 135 children diagnosed with ASD were included. The sample population had a mean age of 43 months (range 13-61 months) and 107 (79%) were males. Thirty (22.2%) patients in the cohort had a HC which was classified as macrocephalic. Almost half (46.7%) had an ASD severity level of three and 94 (69.6%), had been diagnosed with a comorbidity. In this study no significant association was found between macrocephaly and ASD severity. Conclusions: Measuring the HC during childhood is a cost-effective, simple and non-invasive procedure that may well assist professionals in raising suspicion of ASD at an early age. Early detection and intervention could optimise participation and integration for the individual living with this life-long neurodevelopmental disability.

The End-to-end Fetal Head Circumference Detection and Estimation in Ultrasound Images.

In prenatal examinations, the fetal head circumference (HC) measurement is essential for assessing fetal weight and health conditions. The sonographers obtain the fetal HC manually by fitting peripheral skull ellipse in clinical practice, which is highly subjective, time-consuming, and experience-dependent. Recently, many fetal HC automatic measurement algorithms have been proposed to improve workflow efficiency in prenatal examination. But most automatic measurement algorithms focus on using fetal head segmentation as an intermediate processing step, and HC estimation relies heavily on segmentation results, which causes the accumulation of errors in the above two stages. Independent of the segmentation method, we design a regression network to generate the oriented bounding box to detect the head contour, and directly obtain the fetal head parameters with a pixel-based ellipse regression (PER) loss. Moreover, an effective 3D attention mechanism is integrated into the network to estimate HC more precisely without adding parameters in complex ultrasound images. The extensive experimental results on the public HC18 and our clinical dataset show that the proposed network provides a feasible scheme for end-to-end estimating fetal HC, and avoids the mistake brought by the intermediary processes.

Neck strength alone does not mitigate adverse associations of soccer heading with cognitive performance in adult amateur players.

Soccer heading is adversely associated with neurocognitive performance, but whether greater neck strength or anthropometrics mitigates these outcomes is controversial. Here, we examine the effect of neck strength or anthropometrics on associations of soccer heading with neurocognitive outcomes in a large cohort of adult amateur players. 380 adult amateur league soccer players underwent standardized measurement of neck strength (forward flexion, extension, left lateral flexion, right lateral flexion) and head/neck anthropometric measures (head circumference, neck length, neck circumference and neck volume). Participants were assessed for heading (HeadCount) and cognitive performance (Cogstate) on up to 7 visits over a period of two years. Principal components analysis (PCA) was performed on 8 neck strength and anthropometric measures. We used generalized estimating equations to test the moderation effect of each of the three PCs on 8 previously identified adverse associations of 2-week and 12-month heading estimates with cognitive performance (psychomotor speed, immediate verbal recall, verbal episodic memory, attention, working memory) and of unintentional head impacts on moderate to severe central nervous system symptoms. 3 principal components (PC's) account for 80% of the variance in the PCA. In men, PC1 represents head/neck anthropometric measures, PC2 represents neck strength measures, and PC3 represents the flexor/extensor (F/E) ratio. In women, PC1 represents neck strength, PC2 represents anthropometrics, and PC3 represents the F/E ratio. Of the 48 moderation effects tested, only one showed statistical significance after Bonferroni correction, which was not robust to extensive sensitivity analyses. Neither neck strength nor anthropometrics mitigate adverse associations of soccer heading with cognitive performance in adult amateur players.

Neonatal outcomes of patients with vaginal delivery after a Caesarean section

Purpose: The rates of caesarean section (CS) have been increasing in recent years in Türkiye and throughout the world. A previous CS is known to not be an absolute indication for repeat CS, and vaginal delivery (VD) (trial of labor after caesarean (TOLAC)) can occur after a CS. The aim of this study was to investigate the neonatal outcomes of TOLAC patients in Konya City Hospital.&#x0D; Materials and Methods: A retrospective analysis was made of the records of all the births in Konya City Hospital between 10 August 2020 and 10 June 2022. The study included all patients with full or nearly complete cervical dilation-effacement and who had a previous CS. These patients were compared with patients who had elective CS and VD. A total of 119 patients were included in the study in 3 groups; TOLAC n:32, CS n:42, VD n:45.&#x0D; Results: TOLAC patients gave birth earlier and the infant birth weight (2991.25gr), length (50.66cm) and head circumference (34.09cm) measurements were found to be significantly lower than those of the other groups. The development of any problem (icterus, respiratory distress syndrome (RDS), oxygen requirement, hypoglycemia, hypothermia) was determined at a significantly higher rate in the TOLAC (21.9%).&#x0D; Conclusion: Patients with a history of CS do not have to have a repeat CS. TOLAC can be performed in appropriate cases, but care should be taken against uterine rupture, the need for emergency CS, and adverse neonatal outcomes.

Design, Implementation, and Evaluation of the “Simultaneous Measurement of Infants’ Weight, Height, Head Circumference, Temperature, and Heart Rate Digital Device”

Background: The measurement of various components of infant growth is not only essential for monitoring infant health but is also associated with the well-being of infants and their parents, the use of human resources, frequent repositioning of infants, and a considerable amount of time. Objectives: Therefore, the present study aimed to design and evaluate a device for the “simultaneous measurement of infants’ weight, height, head circumference, temperature, and heart rate”. Methods: This study follows a quantitative and semi-experimental approach. The “simultaneous measurement of weight, height, head circumference, temperature, and heart rate of a child” device was officially registered as an invention with the number 104232 on May 18, 2021. The sample for this study comprised 100 infants selected from hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran. The data related to all 100 infants were collected and recorded using both routine measurement methods and digital devices. Data collection tools included the Wong-Baker Faces scale to assess infant distress and a demographic questionnaire for recording growth components and the time of measurement. Data analysis was conducted using SPSS software (version 20), and statistical significance was determined using the t-test (P &lt; 0.05). Results: The comparison of mean distress scores in both the control and intervention groups revealed a significant reduction in infant distress scores during all measurements except for weight (P &lt; 0.05). It is worth noting that the number of infant repositions required for each measurement was reduced from 6 in the routine method to 2 with the digital device. Additionally, although 2 or 3 staff members were needed for measurements in the control group, only 1 staff member was sufficient for measurements in the intervention group. Discussion: Based on the evaluation results of the digital device, it is anticipated that this device could serve as a suitable alternative to the routine methods of measuring infant growth components. However, further studies are warranted to explore the broader applications of this digital device.

Comparison of Effect of Human Milk Fortification with Preterm Formula Powder Vs Human Milk Fortification with Human Milk Fortifier on the Growth of Very Low Birth Weight Newborns

Aim: The primary aim of this scientific inquiry was to comprehensively assess how the nourishment of Very Low Birth Weight (VLBW) newborns could be improved by supplementing their diet with either human milk fortifier or preterm formula powder. Methods: A randomized controlled trial was carried out at RTEH Muzaffargarh NICU, which involved the participation of 72 preterm infants weighing between 1.2 kg and 1.6 kg at birth. The infants were randomly allocated into two groups: one received human milk fortified with preterm formula powder. In contrast, the other group received human milk fortified with a human milk fortifier. Throughout the study, weight, length, and head circumference measurements were taken for all participants. Results: There were no significant differences in gestational ages between HMF and preterm formula groups (p=0.057), nor in gender distribution (p=0.369 for males). Post-intervention, Group A experienced significant increases in birth weight (p=0.0021) and head circumference (p=0.004), but not in length. In the control group, changes in weight, head circumference, and length did not reach statistical significance. Conclusion: Human milk fortification with preterm formula powder appears to promote similar or even better growth outcomes in VLBW infants when compared to traditional fortification with human milk fortifier. However, more research is needed to confirm these findings and assess any potential long-term impacts. Keywords: Human Milk Fortification, Preterm Formula Powder, Very Low Birth Weight Infants, Growth Outcomes, Randomized Controlled Trial.