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A prospective cohort study of head circumference and its association with neurodevelopmental outcomes in infants and young children in rural Guatemala

Published online by Cambridge University Press:  22 April 2022

Amy K. Connery Open the ORCID record for Amy K. Connery [Opens in a new window] ,
Molly M. Lamb ,
Alison M. Colbert ,
Desirée Bauer ,
Daniel Olson ,
Alejandra Paniagua-Avila ,
Mirella Calvimontes ,
Guillermo Antonio Bolaños ,
Hana M. El Sahly  and
Flor M. Muñoz
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Amy K. Connery*
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
Molly M. Lamb
Affiliation:
Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
Alison M. Colbert
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
Desirée Bauer
Affiliation:
Center for Human Development, Fundación Para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
Daniel Olson
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
Alejandra Paniagua-Avila
Affiliation:
Center for Human Development, Fundación Para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
Mirella Calvimontes
Affiliation:
Center for Human Development, Fundación Para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
Guillermo Antonio Bolaños
Affiliation:
Center for Human Development, Fundación Para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
Hana M. El Sahly
Affiliation:
Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
Flor M. Muñoz
Affiliation:
Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Edwin J. Asturias
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
*
Address for correspondence: Amy K. Connery, Children’s Hospital Colorado, Aurora, CO, USA. Email: amy.connery@childrenscolorado.org
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Abstract

Microcephaly, an anthropometric marker of reduced brain volume and predictor of developmental disability, is rare in high-income countries. Recent reports show the prevalence of microcephaly to be much higher in lower resource settings. We calculated the prevalence of microcephaly in infants and young children (n = 642; age range = 0.1–35.9 months), examined trends in occipitofrontal circumference (OFC) growth in the year after birth and evaluated the relationship between OFC and performance on the Mullen Scales of Early Learning (MSEL) in rural Guatemala. Multivariable regression analyses adjusted for age were performed: (1) a model comparing concurrent MSEL performance and OFC at all visits per child, (2) concurrent OFC and MSEL performance by age group, and (3) OFC at enrollment and MSEL at final visit by age group. Prevalence of microcephaly ranged from 10.1% to 25.0%. OFC z-score decreased for most infants throughout the first year after birth. A significant positive association between continuous OFC measurement and MSEL score suggested that children with smaller OFC may do worse on ND tests conducted both concurrently and ∼1 year later. Results were variable when analyzed by OFC cutoff scores and stratified by 6-month age groups. OFC should be considered for inclusion in developmental screening assessments at the individual and population level, especially when performance-based testing is not feasible.

Keywords

Assessmenthead circumferencelow resource settingsneurodevelopmentyoung children
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 6 , December 2022 , pp. 779 - 786
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Copyright
© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Footnotes

*

Co-first authors

†

Co-senior authors

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