Head Circumference Measurements Research Articles

Ellipse guided multi-task network for fetal head circumference measurement

Precise fetal head circumference measurement by ultrasound imaging is of great significance for prenatal examination. However, missing or blurring boundaries caused by artifacts and noises challenge measurement accuracy. The inconsistency between the segmentation pseudo-label and the ellipse contours also generates measurement errors. To improve the measurement performances of fetal head circumference, in this study, we propose an ellipse-guided multi-task network that measures the fetal head circumference according to detected ellipse boundary pixels. In the proposed network, an region segmentation branch is designed to learn region features of the fetal head, and a feature fusion module is applied to combine region features with boundary features, which contribute to exploring more context information about the fetal head and locating boundary pixels in boundary missing or blurring regions. A loss function is also designed in the network to ensure the boundary estimation in an ellipse shape. Experiments are conducted on both the public fetal head circumference measurement dataset HC-18 and a self-built ultrasonic phantom dataset. The experimental results show that the proposed method achieves DSC 97.97%, HD 1.22 mm, and ADF 1.85 mm, which demonstrates that the proposed method achieves excellent performance to compete with other state-of-the-art methods in fetal head circumference measurement.

Second-trimester growth velocities in twin and singleton pregnancies.

Previous small studies used individualized growth assessment (IGA) to characterize prenatal growth velocities of singletons and twins. We aimed to compare second-trimester growth velocities of individual anatomical parameters between monochorionic diamniotic (MCDA) twins, dichorionic diamniotic (DCDA) twins and singleton fetuses in a larger study. This was a study of a novel cohort of 222 MCDA twins and previously published cohorts of 40 DCDA twins and 118 singletons with serial ultrasound data. Fetal biometric measurements of biparietal diameter, head circumference, abdominal circumference and femur diaphysis length from prenatal ultrasound examinations were used to calculate second-trimester growth velocities using direct calculation or linear regression analysis. Linear fit was assessed based on the coefficient of determination (R2 ). Mean growth velocities and variances were compared among the three groups. The majority of cases underwent three second-trimester ultrasound examinations with fetal biometry available. All fetuses had linear growth, with R2 > 99% for all parameters. Only 1-2% of all MCDA and DCDA anatomical parameters had abnormal growth velocity scores outside the 95% reference range for singletons. There were no significant differences in mean growth velocity for any parameter between MCDA twins and singletons. Femur diaphysis length growth velocity was significantly lower in DCDA twins than in both MCDA twins and singletons. There were no other significant differences among the groups. Expanding on prior work using IGA, we found that second-trimester growth velocity of the four major anatomical parameters overall was similar between twins and singletons and between MCDA and DCDA twins, supporting the use of singleton-derived growth standards for IGA in twins. Twin growth potential appears to be similar to that of singletons in the second trimester, suggesting that subsequent growth divergence may be due to third-trimester physiological or pathological changes in twin pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Gestational exposure to organophosphate esters and infant anthropometric measures in the first 4 weeks after birth.

Few studies have examined whether gestational exposure to organophosphate esters (OPEs), widely used chemicals with potential endocrine-disrupting potency and developmental toxicity, is associated with impaired infant growth. We analyzed data from 329 mother-infant pairs in the Health Outcomes and Measures of the Environment (HOME) Study (2003-2006, Cincinnati, Ohio, USA). We quantified concentrations of four OPE metabolites in maternal urine collected at 16 and 26 weeks of gestation, and at delivery. We calculated z-scores using 2006 World Health Organization (WHO) child growth standards for the 4-week anthropometric measures (weight, length, and head circumference), the ponderal index, and weekly growth rates. We used multiple informant models to examine window-specific associations between individual OPE metabolites and anthropometric outcomes. We further modeled OPEs as a mixture for window-specific associations with 4-week anthropometric outcomes using mean field variational Bayesian inference procedure for lagged kernel machine regression (MFVB-LKMR). We stratified the models by infant sex. Diphenyl phosphate (DPHP) in mothers at 16 weeks, and bis(2-chloroethyl) phosphate (BCEP) and bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) at delivery were positively associated with z-scores of weight, length, and head circumference in all infants at 4 weeks of age. After stratifying by infant sex, positive associations were only observed in males for DPHP at 16 weeks and BCEP at delivery and in females for BDCIPP at delivery. Negative associations not present in all infants were observed in males for di-n-butyl phosphate (DNBP) at 26 weeks of gestation with weight z-score and DPHP at delivery with head circumference z-score. Results were generally similar using MFVB-LKMR models with more conservative 95 % credible intervals. We did not identify consistent associations of gestational OPE metabolite concentrations with the ponderal index and weekly growth rates. In this cohort, exposure to OPEs during gestation was associated with altered infant anthropometry at 4 weeks after birth.

Türk Çocuklarında Baş Çevresinin Normal Değerleri

Objective: Measuring head circumference is a quick, simple, cheap, noninvasive and reliable procedure for determining underlying brain size and provides information about risk for medical problems. Growth percentages of head vary from one community to another.
 Methods: We aim to create head circumference growth curves for children aged 0-18 years in Turkish community. Measurements were performed by same person using a rigid and calibrated tape meter. In addition, the parents were asked to fill out a questionnaire with variables that could affect children's growth.
 Results: Data analysis has shown that there is no relationship between the children's head circumference and whether there exists someone with a large/small head circumference in their families, or the average monthly income of their families and the parent’s education level. Only the independent variables child’s school performance, birth weight, nutrition, smoking are significantly effective on the HC measures of boys at alpha=0.05 level. For girls, only the independent variables birth weight and nutrition form are significantly important in explaining the variability of HC at the level of alpha=0.05. One gram increase in birth weight causes a 0.001 cm increase in the HC of both genders. In addition, head circumference growth curves were created for both genders to include all children aged 0-18.
 Conclusions: Our study offers recent and gender-specific head circumference norms. These new values can be used more effectively in child follow-up.

Ambient temperature during pregnancy and fetal growth in Eastern Massachusetts, USA.

Left unabated, rising temperatures pose an escalating threat to human health. The potential effects of hot temperatures on fetal health have been under-explored. Here, we examined the association between prenatal ambient temperature exposure and fetal growth measures in a Massachusetts-based pregnancy cohort. We used ultrasound measurements of biparietal diameter (BPD), head circumference (HC), femur length and abdominal circumference (AC), in addition to birthweight (BW), from 9446 births at Beth Israel Deaconess Medical Center from 2011 to 2016. Ultrasound scans were classified into three distinct gestational periods: 16-23 weeks, 24-31 weeks, 32+ weeks; and z-scores were created for each fetal growth measure using the INTERGROWTH-21st standards. We fitted distributed lag models to estimate the time-varying association between weekly temperature and fetal growth, adjusting for sociodemographic characteristics, seasonal and long-term trends, humidity and particulate matter (PM2.5). Higher ambient temperature was associated with smaller fetal growth measures. The critical window of exposure appeared to be Weeks 1-20 for ultrasound parameters, and high temperatures throughout pregnancy were important for BW. Associations were strongest for head parameters (BPD and HC) in early to mid-pregnancy, AC late in pregnancy and BW. For example, a 5ºC higher cumulative temperature exposure was associated with a lower mean AC z-score of -0.26 (95% CI: -0.48, -0.04) among 24-31-Week scans, and a lower mean BW z-score of -0.32 (95% CI: -0.51, -0.12). Higher temperatures were associated with impaired fetal growth. This has major health implications given that extreme temperatures are more common and escalating.

The effect of biacromial and bideltoid distance on shoulder dystocia and birth weight in newborns

To evaluate the relationship between neonatal biacromial and bideltoid diameter (BDD), birth weight and shoulder dystocia (SD). This was a prospective observational study conducted on 161 pregnancies who applied to Private Lokman Hekim Hospital for follow-up between February 2021 and August 2021. Maternal height, weight, parity, and presence of SD in the second stage of labor were evaluated in the patients included in the study. The weight, height, head circumference, biacromial and BDD measurements of newborn babies were taken within the first two hours after birth. The primary purpose of the study was to evaluate the relationship between the biacromial and BDD and SD. The secondary purpose of the study was to evaluate the relationship between the biacromial and BDD and macrosomia. The mean age and post-pregnancy body mass index of the participants were 31.3±4.4 years and 29.0±4.0 kg/m2, respectively, and 42.9% (n=69) delivered vaginally. The incidence of macrosomia was 6.8% (n=11) in all women and the incidence of SD was 7.2% (n=5) in women who had vaginal deliveries. The mean biacromial diameter (BAD) was 12.4±1.0 cm and the mean BDD was 18.2±1.7 cm. A correlation rate of 0.373 was found between SD and the BAD, and 0.484 between SD and the BDD. The correlation coefficients between macrosomia and the biacromial and BDD were 0.213 and 0.420, respectively. In cases in which the BDD was ≥21 cm, the sensitivity for SD was 100%, the specificity was 90.63%, and the accuracy was 91.30%. The cut-off point for the BAD was ≥14 cm, and the sensitivity and specificity for SD was 63.64% and 89.33%, respectively. The highest correlation for SD was obtained in cases in which there was a history of SD (0.648). The relationship between neonatal biacromial and BDD, and macrosomia and SD were significant. There was no difference between the correlation values of the two measurements in terms of SD. However, the correlation coefficient of the BDD was greater for macrosomia.

Trajectories of child growth, child development, and home child-rearing quality during the Covid pandemic in rural Nepal.

Children, especially disadvantaged children in poor countries, were expected to be among the "biggest victims" of the Covid pandemic. Economic burdens, decreased nutritious foods, reduced medical care, school closures, and ill-health or death of family members were predicted to increase child undernutrition and developmental delays, and diminish home child-rearing quality. A planned nutrition intervention could not be implemented due to Covid restrictions. However, three surveys (pre-Covid [December 2019], July 2021, and September 2021) in 280 Nepali households (309 parent-dyads, 368 children, 6-66 months old) collected demographics, child anthropometry and development (Ages and Stages Questionnaire-3 [ASQ-3]), and home child-rearing quality (caregiver engagement, learning resources, adult supervision [UNICEF's Multiple Indicator Cluster Survey]). Mixed-effect regression models adjusted for household (wealth, maternal education) and child factors (age, gender) and survey round. Height, mid-upper-arm circumference, and head circumference measurements improved over time. The total ASQ-3 score did not change: Communication scores increased while fine motor and personal-social scores declined. Girls' growth and development worsened more than boys. Caregiver engagement (especially mothers') generally declined, but learning resource availability increased. More children were left unsupervised at Round 2 than Round 1 or 3. In this sample, some aspects of child growth, development, and home child-rearing quality improved while others declined. Better understanding of these changes in child well-being and the family environment during the pandemic could provide insight on how to protect children during future crises.

Sharp IR GP2Y0A21 Sensor Calibration for Prototyping Application of Smart Anthropometric System

An anthropometric tool is a tool used to measure body dimensions. For toddlers, anthropometric measurement is necessary to determine their nutritional status. The main anthropometric parameters in toddlers are weight, height, and head circumference. The development of accurate and user-friendly anthropometric tools is very significant in an effort to modernize the Integrated Healthcare Post (posyandu). This study aims to determine the accuracy of the infrared sensor used to measure the height and head circumference of toddlers. One IR GP2Y0A21 sensor was utilized to measure height, and four IR GP2Y0A21 sensors were utilized to measure the head circumference. The calibration results show the relative error of the Sharp IR GP2Y0A21 sensor for height measurement of 0.24%, and the relative error of the GP2Y0A21 sensor on head circumference 1 of 0.51%, head circumference 2 of 0.53%, head circumference 3 of 0.25%, and head circumference 4 of 0.37%. We conclude that the IR GP2Y0A21 sensor has high accuracy and can be used to measure head circumference and height accurately.

Fetal growth trajectories of babies born large-for-gestational age in the LIFECODES Fetal Growth Study

Babies born large-for-gestational age have an increased risk of adverse health outcomes, including birth injuries, childhood obesity, and cardiometabolic disorders. However, little work has been done to characterize patterns of fetal growth among large-for-gestational age births, which may further elucidate high- and low-risk subgroups. This study aimed to identify subgroups of large-for-gestational age births based on trajectories of fetal growth derived from prenatal ultrasound measurements and explore differences in sociodemographic, pregnancy, and birth outcome characteristics across subgroups. This study identified and described trajectories of fetal growth among large-for-gestational age births (n=235) in the LIFECODES Fetal Growth Study. Ultrasound measurements of fetal growth in middle to late pregnancy were abstracted from health records. Group-based multi-trajectory modeling was applied to measurements of head circumference, abdominal circumference, and femur length z-scores to identify multivariate trajectories of fetal growth. Moreover, sociodemographic variables, pregnancy characteristics, and birth outcomes based on trajectory membership were summarized. This study identified 4 multivariate trajectories of fetal growth among large-for-gestational age births: catch-up growth (n=28), proportional abdominal circumference-to-femur length growth (n=67), disproportional abdominal circumference-to-femur length growth (n=96), and consistently large (n=44). Fetuses in the "catch-up growth" group exhibited small relative sizes in midpregnancy (ie, below average head circumference, abdominal circumference, and femur length z-scores) and large relative sizes in late pregnancy. Growth among these births was driven by increases in relative abdominal circumference and head circumference sizes. Participants who delivered births assigned to this group were less likely to have normal glucose control (40% vs 65%-75%) and more likely to have pregestational diabetes mellitus (36% vs 10%-17%) than other large-for-gestational age subgroups. In addition, the babies in this trajectory group were more likely to have macrosomia (86% vs 67%-73%) and to be admitted to the neonatal intensive care unit (32% vs 14%-21%) than other large-for-gestational age subgroups. In contrast, babies in the "consistently large" group had the largest relative size for all growth parameters throughout gestation and experienced a lower risk of adverse birth outcomes than other large-for-gestational age subgroups. This study characterized several trajectories of fetal growth among large-for-gestational age births, which were related to different pregnancy characteristics and the distribution of adverse birth outcomes. Although the number of individuals within some trajectories was small, a subgroup that exhibited a catch-up growth phenotype during gestation was identified, which may be uniquely associated with exposure to pregestational diabetes mellitus and a higher risk of admission to the neonatal intensive care unit. These results have highlighted that the risk of adverse outcomes may not be evenly distributed across all large-for-gestational age births.

Bland-Altman Plot: Agreement Between Ultrasound-measured Placenta Thickness and Other Biometric Parameters in the Determination of Gestational Age.

The aim of this article is to evaluate the agreement of placenta thickness (PT) with other foetal biometric parameters in the determination of gestational age (GA) in normal singleton foetuses. The study was a cross-sectional descriptive study conducted among 406 consecutively recruited pregnant women with singleton foetuses at 15-40 weeks of gestation at the National Hospital, Abuja, Nigeria from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard measurement protocols. Bland and Altman (BA) plots were used to compare PT and other foetal biometric parameters. The significant statistical level was determined at a critical value of P < 0.05. The mean age of study participants was 31.8 ± 4.8 years. The BA plot of PT and HC demonstrated a normal distribution; the mean difference was around zero (3.968) and 95% of the measurements fell within 2SD of the mean. The BA plot of HC and AC measurements also showed that the 95% limits of agreement for differences fell within 10% of the mean of the measurements (-4.236 to 15.987 with a mean difference of 5.876), indicating good agreement between the two pairs of variables. However, BA plots between PT and BPD as well as PT and FL showed no agreement. This study indicates that there is good agreement or comparability between PT and HC measurements as well as between PT and AC measurements. Hence, either HC or AC measurements may be interchangeable with PT measurements in the ultrasound determination of GA. However, PT measurements did not agree well with BPD and FL measurements, respectively.

Comparison of the Results of Suture and Resorbable Plate-Screw Fixation in Craniosynostosis

Although many fixation methods are used alone or in combination for craniosynostosis, only few studies have compared the effectiveness and long-term results of these methods. In this study, patients in whom suture or resorbable plate-screw system was used for fixation were evaluated in terms of postoperative results and complications. The data of patients who underwent surgery for craniosynostosis between 2002 and 2019 were retrospectively reviewed and evaluated. A total of 70 patients, 41 in the suture group and 29 in the resorbable plate-screw group, were included in the study. Whitaker classification was used for head shape evaluation, and anthropometric head circumference measurements were performed in all patients in the preoperative and postoperative periods. In the postoperative period, all patients were compared in terms of the operation time, transfusion requirement, discharge, follow-up period, and complications according to the chosen fixation method.The mean age, postoperative complication rates, anthropometric head circumference measurements, and Whitaker scores of both groups were found to be statistically similar. Although the resorbable plate-screw group had a longer follow-up period, the operation time was longer in the suture group. Furthermore, the suture group had lower transfusion requirement and earlier discharge from the hospital than the resorbable plate-screw group. If fixation with suture is chosen in suitable patients, in addition to the low patient cost, this method can be safely applied in centers with limited logistical possibilities, because of the results and complication rates being similar to fixation with resorbable plate-screws.

The relation of residential greenness with fetal growth and the role of air pollution in Eastern Massachusetts, USA

Background and Aim: There is growing evidence that green spaces may be beneficial for health. However, the effects on pregnant individuals and fetuses, including the underlying mechanisms, have been underexplored. We examined the association between neighborhood greenness and fetal growth, and the role of air pollution in these relationships (interaction and mediation) in a Massachusetts-based cohort. Methods: Our study consisted of 9,446 pregnancies that delivered at Beth Israel Deaconess Medical Center, Massachusetts in 2011-2016. Neighborhood greenness was estimated using normalized difference vegetation index (NDVI) with 270 m resolution. Fetal growth parameters included birth weight (BW), and ultrasound measures of biparietal diameter (BPD), head circumference (HC), femur length, and abdominal circumference (AC). Ultrasound parameters were classified into three distinct gestational periods: 16-23 weeks, 24-31 weeks, and 32+ weeks. We used distributed lag models to estimate the time-varying association between monthly NDVI and fetal growth. All models were adjusted for sociodemographic characteristics, and time trends. For models in which we identified an association, we tested for potential interaction with particulate matter &amp;#x2264;2.5 µm (PM2.5) and nitrogen dioxide (NO2) —predicted from well-validated ensemble models— and assessed for mediation by these pollutants. Results: We found that higher NDVI was positively associated with BPD, HC, AC, and BW. For example, a 0.1 NDVI increase sustained up until week 32 was associated with a higher mean AC z-score of 0.03 (95% CI: 0.01, 0.06), and a higher mean BW z-score of 0.02 (95% CI: 0.01, 0.03). We found no evidence for interaction or mediation by air pollution. Conclusions: Residential greenness was associated with larger fetal growth measures. Our effect decomposition suggests that the association of greenness with fetal growth is independent from associations with local air pollution. Keywords: greenness, air pollution, fetal growth, ultrasound, pregnancy, interaction, mediation

Traffic-related air pollution and fetal growth in Eastern Massachusetts, USA

Background and Aim: Previous studies have examined the association between prenatal nitrogen dioxide (NO2) —a traffic emissions tracer— and fetal growth based on ultrasound measures during pregnancy. Yet, most have used exposure assessment methods with low temporal resolution, which limits the identification of critical exposure windows given that pregnancy occurs over a relatively short period. Here, we used NO2 data estimated from a high-resolution spatiotemporal model to examine the association between weekly NO2 exposure during pregnancy and fetal growth in a Massachusetts-based cohort. Methods: We used data from 9,446 singleton births at Beth Israel Deaconess Medical Center in 2011-2016. Fetal growth parameters included birth weight, and ultrasound measures of biparietal diameter (BPD), head circumference (HC), femur length, and abdominal circumference. Ultrasound parameters were classified into three distinct gestational periods: 16-23 weeks, 24-31 weeks, and 32+ weeks. We used distributed lag models to estimate the time-varying association between weekly NO2 exposure and fetal growth. All models were adjusted for sociodemographic characteristics, time trends, particulate matter less than 2.5 microns (PM2.5), and temperature. Results: We found that higher NO2 was negatively associated with all fetal growth parameters. The critical window differed depending on the fetal growth parameter and when it was assessed, with associations particularly strong for head parameters. For example, for BPD and HC measured after week 32, the critical exposure window appeared to be around weeks 15-25; a 10-ppb higher NO2 exposure sustained from conception to the time of measurement was associated with a lower mean z-score of -0.26 (95% CI: -0.39, -0.13) and -0.13 (95% CI: -0.25, 0.00) for BPD and HC, respectively. Conclusions: Higher NO2 was associated with smaller fetal growth measures. We identified several critical exposure windows that varied by parameter and timing of measurement. Keywords: air pollution, traffic, nitrogen dioxide, fetal growth, ultrasound, pregnancy, critical window

Local clinical informatics investments are required for in silico biomarker generation across the globe: lessons learned from a secondary analysis of the PROP trial

Background Advances in statistical modelling and machine learning approaches, which can be deployed locally using open source programming languages, represent a unique opportunity to improve workflows and lower costs in health care across the globe through the creation of in silico biomarkers. The goal of this study was to extract meaningful data from the publicly available Prematurity and Respiratory Outcomes Program (PROP) trial data that could help generate useful clinical diagnostic aids with minimal cost for deployment in global healthcare settings. Methods A cluster analysis of the PROP dataset was conducted. We generated a simple model using an open-source software platform that generates a growth prediction of patients born less than 30 weeks. We then obtained validation data from a Uruguayan hospital to test the capacity for deployment of the models. Results Analysis revealed two main clusters of patients in the trial, with differentiation mainly based on the clinical and anthropomorphic measurements of birth gestational age, birth weight, and head circumference. The anthropometric measurements of daily weight, birth weight, head circumference, and birth gestational age were highly correlated with respiratory dysfunction and co-morbidities We note that deviation from this predicted growth curve in PROP patients was associated with culture-proven sepsis, and may represent a more sensitive anthropomorphic biomarker than the weight percentile systems routinely used globally such as Fenton curves. We found that early deviation from our projected growth model was highly associated with patient fatality. However, over long-term predictions, models trained on PROP clinical trial patients showed significantly more error in the Uruguayan patients. Conclusions Although these prediction models built upon PROP data were not generalizable to Uruguayan patients, our data suggest that prediction models using simple anthropomorphic measurements, if trained on local patients, may be able to provide value as a low-cost in silico biomarker. We concluded that local investment in clinical informatics infrastructure is needed to train models based on locally extracted clinical data.

Accuracy of the sonographic determination of estimated fetal weight in anhydramnios.

To determine whether the presence of anhydramnios significantly influences the sonographic estimated fetal weight (EFW) compared to a matched cohort with normal amniotic fluid volume. The study sample of this retrospective case-control study consisted of 114 pregnant women who presented to a Tertiary Perinatal Clinic between 2015 and 2020. 57 of them presented with an anhydramnios and a matched cohort of 57 women with normal amniotic fluid volume. At time of admission, gestational age varied between 22 +4 and 42 +6weeks of pregnancy. All women underwent detailed ultrasound assessment for EFW and amniotic fluid index. To determine EFW Hadlock's estimation formula I was used which is based on measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). The EFW was compared with the weight at delivery. The maximum time interval between measurement and delivery was 5days. There was neither a significant difference between the case and control group with regard to gestational age at ultrasound in days (median 249days and 246days, p = 0.97), nor to gestational age at birth (median 249days and 247days, p = 0.98). Concerning the newborns parameters, the body length at birth was not significantly different between the case and control group in centimeters (cm) (median 47cm and 47cm, p = 0.79). EFW in gram (g) was lower than birth weight in both groups and did not differ significantly between case and control group (estimated weight median 2247g and 2421g, p = 0.46; birth weight median 2440g and 2475g, p = 0.47). The difference between EFW and birth weight in percent (%) did not differ between the case and control group (median -3.9% and -5.6%, p = 0.70). The maternal parameters showed that the patients in the case group were younger (median 31years and 38years p = 0.20) and had a significantly higher body mass index (BMI) (median 27.3kg/m2 vs 22.0kg/m2, < 0.001) compared to the control group. Our study shows for the first time that EFW in women with anhydramnios can be determined sonographically just as accurately as in a matched cohort with normal amniotic fluid volume. A reliable estimation of fetal weight is crucial for optimal assessment of the newborns prognosis and counseling of the parents especially when advising women in the early weeks of pregnancy at the limit of viability.

Head circumference and anthropometric changes and their relation to plexiform and skin neurofibromas in sporadic and familial neurofibromatosis 1 Brazilian adults: a cross-sectional study

BackgroundNeurofibromatosis 1 (NF1) is a common autosomal dominant syndrome with complete penetrance and highly variable expressivity. The cutaneous neurofibroma (Cnf) and plexiform neurofibroma (Pnf), café-au-lait spots, and freckle-like lesions are common in NF1, but many other manifestations can occur. We aimed to evaluate head circumference, height, weight, body mass index (BMI), head circumference-to-height ratio (HCHR) and waist–hip ratio (WHR) in adult NF1 Brazilian individuals versus a paired control group and investigate their correlation with the presence of clinically visible Pnfs, and number of “skin neurofibromas” (Snf), which include both cutaneous and subcutaneous neurofibromas.MethodsA case–control study was conducted with 168 individuals, 84 with NF1 and 84 without NF1, paired by sex and age. Head circumference and anthropometric measurements, Snf quantification, evaluation of clinically visible Pnf and familial inheritance were accessed.ResultsPrevalence of macrocephaly was significantly higher in NF1 women. Height and weight were significantly lower in both males and females with NF1. HCHR was higher in the NF1 group than in the control group for both sexes. BMI was significantly lower in men with NF1. Waist and hip circumferences were significantly reduced in NF compared with the controls, but the mean WHR was significantly lower only in NF1 women. No correlation was found between the Snf and head circumference and anthropometric measurements, sex or family history. The presence and larger size of clinically visible plexiform neurofibromas were associated with normal stature (p = 0.037 and p = 0.003, respectively).ConclusionsNF1 individuals have increased prevalence of macrocephaly, short stature, low BMI, and reduced abdominal fat. There is no relation between head circumference and anthropometric data with family history, or neurofibromas.

An application of group-based trajectory modeling to define fetal growth phenotypes among small-for-gestational-age births in the LIFECODES Fetal Growth Study

Reductions in fetal growth are associated with adverse outcomes at birth and later in life. However, identifying fetuses with pathologically small growth remains challenging. Definitions of small-for-gestational age are often used as a proxy to identify those experiencing pathologic growth (ie, fetal growth restriction). However, this approach is subject to limitation as most newborns labeled small-for-gestational age are constitutionally, not pathologically, small. Incorporating repeated ultrasound measures to examine fetal growth trajectories may help distinguish pathologic deviations in growth from normal variability, beyond a simple definition of small-for-gestational age. This study aimed to characterize phenotypes of growth using ultrasound trajectories of fetal growth among small-for-gestational-age births. This study identified and described trajectories of fetal growth among small-for-gestational-age births (<10th percentile weight for gestational age; n=245) in the LIFECODES Fetal Growth Study using univariate and multivariate trajectory modeling approaches. Available ultrasound measures of fetal growth (estimated fetal weight, head circumference, abdominal circumference, and femur length) from health records were abstracted. First, univariate group-based trajectory modeling was used to define trajectories of estimated fetal weight z scores during gestation. Second, group-based multi-trajectory modeling was used to identify trajectories based on concurrent measures of head circumference, abdominal circumference, and femur length z scores. Last, how these trajectories were related to patient demographics, pregnancy characteristics, and birth outcomes compared with those observed among appropriate-for-gestational-age controls was described. Of note, 3 univariate trajectories of estimated fetal weight and 4 multivariate trajectories of fetal growth among small-for-gestational-age births were identified. In our univariate approach, infants with the smallest estimated fetal weight trajectory throughout pregnancy had poorer outcomes, including the highest risk of neonatal intensive care unit admission. The remaining univariate trajectory groups did not have an elevated risk of adverse birth outcomes relative to appropriate-for-gestational-age controls. In our multivariate approach, 2 groups at increased or moderately increased risk of neonatal intensive care unit admission were identified, including infants that remained extremely small for all parameters throughout pregnancy and those who had disproportionately smaller femur length and abdominal circumference compared with head circumference. The remaining multivariate trajectory groups did not have an elevated risk of adverse birth outcome relative to appropriate-for-gestational-age controls. Latent class group-based trajectory modeling applied to ultrasound measures of fetal growth may help distinguish pathologic vs constitutional growth profiles among newborns born small-for-gestational age. Although trajectories cannot be fully characterized until delivery, limiting the direct clinical application of these methods, they may still contribute to the development of approaches for separating growth restriction from constitutional smallness.

Sharing Pesan Gizi Seimbang dan Monitoring Pertumbuhan Anak Usia Dini di TK Pertiwi Singodutan II

The purpose of this activity is to do community service, especially in the health sector, that can improve the health status of children through monitoring children's growth and sharing balanced nutrition messages in TK Pertiwi Singodutan II. The implementation of this community service activity began with the lecture method and discussion between the Service team and Singodutan II Kindergarten students through sharing messages of balanced nutrition. Then proceed with early detection of growth irregularities through measurements of height, weight, and head circumference. The impact of this community service activity is information on the nutritional status of TK Pertiwi Singodutan II students (based on measurements of height, weight, and head circumference) which can be conveyed to parents as a reference to further improved the health status of early childhood.

Usulan Standar Tingkat Pencapaian Perkembangan Anak Usia 0-1 Tahun

This article discusses the process of growth and development of children aged 0-1 years which is continuous throughout the stages of life, but the speed of growth varies according to the stages of age. Growth is a change in the number, size, size of the body or limbs, which can be physically measured through weighing, measuring height, measuring head circumference, arm circumference and others. Development is the increase in abilities or skills in more complex body structures and functions in a regular and predictable pattern as a result of experience and the process of movement, intellectual, social and emotional maturation. Development is influenced by heredity, environment, culture and family values in each individual. The combination of these factors gives rise to the wide variety of variations that can be observed in children. Growth and development occur very rapidly, therefore stimulation of children at this age is very important because healthy and intelligent children will grow and develop optimally. The rate of growth and development of children aged 0-1 years which is described in various sources and guidelines in the national curriculum, there are proposed indicators of development in aspects of language development, namely the ability to express language and listen through non-verbal communication through children's reading books.

Fetal Disseminated Malignant Rhabdoid Tumor.

Fetal Disseminated Malignant Rhabdoid Tumor.