Giacomini Isabel, Villamor Eduardo, Lourenço Bárbara Hatzlhoffer, Zhu Mia, Seeley Allison L, Matijasevich Alicia, Cardoso Marly Augusto
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Paediatr Perinat Epidemiol. 2025 Jan;39(1):70-80. doi: 10.1111/ppe.13130. Epub 2024 Oct 4.
Previous evidence on the relation between early head circumference (HC) growth and behavioural outcomes in preschoolers has been inconsistent.
We aimed to investigate whether HC growth from birth to 5 years of age was related to internalising or externalising behavioural problems at 5 years of age in a sex-specific manner.
Among 303 girls and 318 boys from the MINA-Brazil birth cohort, we examined the associations between changes in HC from birth to 5 years of age and internalising and externalising behaviour problem scores at 5 years according to the Strengths and Difficulties Questionnaire for parents. HC values were transformed into sex- and age-specific z-scores (HCZ) using World Health Organisation standards, and the differences between values at 5 years of age and birth were classified into quintiles. We estimated adjusted mean differences with 95% confidence intervals in behavioural problem scores between HCZ change quintiles using multivariable linear regression by sex. To examine nonlinear associations, we included cubic spline terms.
Head circumference growth from birth to 5 years of age was inversely and nonlinearly associated with internalising problems in girls. Compared with girls at the lowest quintile of HC growth, those above had an adjusted 1.27 (95% confidence interval 0.28, 2.27) points lower mean internalising problems score. This association was mostly driven by HC growth during the first 2 years. We found no association between HC growth and externalising behaviour in either sex.
Impaired HC growth was related to higher mean internalising problem scores at 5 years of age in girls but not in boys. HC growth was not associated with externalising problems.
先前关于幼儿早期头围（HC）增长与行为结果之间关系的证据并不一致。
我们旨在研究从出生到5岁的头围增长是否以性别特异性方式与5岁时的内化或外化行为问题相关。
在巴西MINA出生队列的303名女孩和318名男孩中，我们根据家长版优势与困难问卷，研究了从出生到5岁的头围变化与5岁时内化和外化行为问题得分之间的关联。使用世界卫生组织标准将头围值转换为性别和年龄特异性z分数（HCZ），并将5岁时与出生时的值之差分为五分位数。我们使用按性别分类的多变量线性回归估计了HCZ变化五分位数之间行为问题得分的调整后平均差异及其95%置信区间。为了检验非线性关联，我们纳入了三次样条项。
从出生到5岁的头围增长与女孩的内化问题呈负向非线性关联。与头围增长处于最低五分位数的女孩相比，头围增长较高的女孩调整后的内化问题平均得分低1.27（95%置信区间0.28，2.27）分。这种关联主要由头两年的头围增长驱动。我们发现头围增长与任何性别的外化行为均无关联。
头围增长受损与5岁女孩较高的内化问题平均得分相关，但与男孩无关。头围增长与外化问题无关。
