Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.
National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania.
Eur J Pediatr. 2022 Sep;181(9):3401-3411. doi: 10.1007/s00431-022-04554-0. Epub 2022 Jul 8.
The associations of early-life head circumference (HC) with child neurodevelopmental and mental health among generally healthy population remain unclear. We aimed to examine the associations of early-life HC trajectories with cognitive development and emotional and behavioral problems in adolescence and to identify the HC growth-sensitive period. We conducted a prospective, community-based birth cohort study in rural western China, and 745 adolescents aged 10-14 years were followed between June and December 2016. We assessed their HC eight times during the first 2 years of life and their adolescent cognitive, emotional, and behavioral outcomes using the Wechsler Intelligence Scale for Children-IV and Youth Self-Report-2001, respectively. We applied group-based trajectory modeling to identify the HC trajectories and conditional growth to derive the HC growth-sensitive periods. We identified five distinct HC trajectories characterized as Start below average-then decrease (7.8% of the sample), Start below average-then increase (6.8%), Start average-then decrease (33%), Consistently average (38%), and Consistently above average (14%). Infants in the trajectory of consistently above average had higher cognitive scores in adolescence compared to those from suboptimal trajectories, with adjusted mean differences ranging from 2.84 to 8.99 points. The conditional gains showed that the HC growth-sensitive period was between 0 and 18 months for child cognition. We found null associations between HC measures and adolescent emotional and behavioral problem scores.
Early-life HC trajectories were associated with adolescent cognitive development. HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months, particularly in resource-limited settings.
• Postnatal head circumference (HC) has been shown to be associated with cognitive development in infants who were born premature and/or fetal growth restriction, while inconsistent associations were reported among generally healthy populations, especially in low- and middle- income countries, challenging its utility in public health practices.
• Adolescents in the HC growth trajectory of consistently above average had higher cognitive scores compared to those with other suboptimal trajectories, while null findings were observed for adolescent emotional and behavioral health. • HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months of life, particularly in resource-limited settings.
本研究旨在探讨婴幼儿期头围（HC）轨迹与青少年认知发展和情绪行为问题的关系，并确定 HC 生长敏感期。
我们进行了一项在中国西部农村进行的前瞻性、基于社区的出生队列研究，在 2016 年 6 月至 12 月期间对 745 名 10-14 岁的青少年进行了随访。我们在生命的前 2 年内对他们的 HC 进行了 8 次评估，并分别使用韦氏儿童智力量表-IV 和青少年自我报告-2001 评估了他们的青少年认知、情绪和行为结果。我们应用基于群组的轨迹建模来识别 HC 轨迹，并进行条件增长以得出 HC 生长敏感期。
我们确定了五种不同的 HC 轨迹，特征为：开始低于平均水平-然后下降（占样本的 7.8%）、开始低于平均水平-然后增加（6.8%）、开始平均水平-然后下降（33%）、持续平均水平（38%）和持续高于平均水平（14%）。与来自次优轨迹的婴儿相比，持续高于平均水平轨迹的婴儿在青少年时期的认知得分更高，调整后的平均差异范围为 2.84 至 8.99 分。条件增益表明，HC 生长敏感期为 0 至 18 个月，与儿童认知有关。
婴幼儿期 HC 轨迹与青少年认知发展有关。HC 可能成为一种廉价的筛查工具，用于在生命的头 18 个月内监测有风险的儿童发育，尤其是在资源有限的环境中。
