Cordes I, Roland E H, Lupton B A, Hill A
Division of Neurology, University of British Columbia, Vancouver, Canada.
Pediatrics. 1994 May;93(5):703-7.
The development of microcephaly after significant hypoxic-ischemic cerebral injury in the full-term newborn has major prognostic significance. However, the onset of microcephaly in this context may be delayed more than 12 months. OBJECTIVES. To determine whether serial head circumference measurements and decreased rate of head growth in asphyxiated full-term newborns during the first few months of life may predict the development of eventual microcephaly. METHODOLOGY. Serial head circumference measurements at 4, 8, and 18 months of age were obtained in 54 full-term newborns who had acute, hypoxic-ischemic encephalopathy. The rate of head growth was determined on the basis of changes in head circumference ratios which are calculated as follows: actual head circumference/mean head circumference for age x 100%. Head circumference ratios were correlated with severity of newborn encephalopathy and outcome at 18 months. RESULTS. A decrease in head circumference ratios of > 3.1% between birth and 4 months of age was highly predictive of the eventual development of microcephaly before 18 months (sensitivity 90%, specificity 85%). CONCLUSIONS. These data demonstrate that serial head circumference measurements during the first 4 months of life and calculation of decreased rate of head growth in full-term newborns with hypoxic-ischemic encephalopathy may predict microcephaly before its actual occurrence.
足月新生儿发生严重缺氧缺血性脑损伤后小头畸形的发展具有重要的预后意义。然而，这种情况下小头畸形的发病可能会延迟超过12个月。目的。确定在窒息足月新生儿出生后的头几个月内进行系列头围测量以及头生长速率降低是否可预测最终小头畸形的发生。方法。对54例患有急性缺氧缺血性脑病的足月新生儿在4、8和18个月龄时进行系列头围测量。根据头围比值的变化确定头生长速率，头围比值的计算方法如下：实际头围/年龄的平均头围×100%。头围比值与新生儿脑病的严重程度及18个月时的结局相关。结果。出生至4个月龄期间头围比值下降>3.1%高度预测18个月前最终小头畸形的发生（敏感性90%，特异性85%）。结论。这些数据表明，对患有缺氧缺血性脑病的足月新生儿在出生后头4个月内进行系列头围测量以及计算头生长速率降低情况可在小头畸形实际发生前进行预测。
