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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

New Reference Curves for Head Circumference at Birth, by Gestational Age

Alexandre Barbier, Ariane Boivin, Woojin Yoon, Danielle Vallerand, Robert W. Platt, François Audibert, Keith J. Barrington, Prakesh S. Shah, Anne Monique Nuyt and the Canadian Neonatal Network
Pediatrics April 2013, 131 (4) e1158-e1167; DOI: https://doi.org/10.1542/peds.2011-3846
Alexandre Barbier
aDepartments of Pediatrics (Neonatology), and
bDepartment of Pediatrics (Neonatology), Faculty of Medicine, McGill University, Montreal, Quebec, Canada;
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Ariane Boivin
aDepartments of Pediatrics (Neonatology), and
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Woojin Yoon
cMaternal-Infant Care (MiCare) Research Centre, Toronto, Ontario, Canada;
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Danielle Vallerand
bDepartment of Pediatrics (Neonatology), Faculty of Medicine, McGill University, Montreal, Quebec, Canada;
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Robert W. Platt
bDepartment of Pediatrics (Neonatology), Faculty of Medicine, McGill University, Montreal, Quebec, Canada;
dDepartment of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada; and
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François Audibert
eObstetrics and Gynecology, Sainte-Justine University Hospital and Research Centre, University of Montreal, Quebec, Canada;
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Keith J. Barrington
aDepartments of Pediatrics (Neonatology), and
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Prakesh S. Shah
cMaternal-Infant Care (MiCare) Research Centre, Toronto, Ontario, Canada;
fDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Anne Monique Nuyt
aDepartments of Pediatrics (Neonatology), and
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Abstract

BACKGROUND: The measurement of head circumference (HC) at birth reflects intrauterine brain development. HC charts currently used in Canada are either dated, mixed-gender, nonrepresentative of lower gestational ages (GAs), or reflective of other populations.

METHODS: To create both birth weight and HC curves, we combined weight and HC data from the Canadian Neonatal Network (CNN) database (admissions in NICUs across Canada) with McGill’s Obstetrical Neonatal Database (MOND; all births at a tertiary hospital in Montreal, Canada). We included CNN data for GAs of 23 to 34 weeks (2003–2007) and MOND data for GAs of 35 to 41 weeks (1995–2006). Nonsingletons, congenital anomalies, and measurements greater than ±4 SD from the mean were excluded. Distributions of birth weight and HC at each GA were statistically (penalized spline regression) smoothed. Birth weight curves were compared with recent Canadian reference curves and HC curves with historical and/or frequently used curves.

RESULTS: We included 39 896 births (3121 births at <30 weeks’ GA) to generate the curves. Current weight curves were similar to Canadian reference charts for both genders. Weight and HC measurements in boys were higher than in girls. When classified according to recent international references, the proportion of CNN-MOND infants at ≥32 weeks’ GA with HCs <10th percentile was significantly underestimated. When classified according to historical reference curves, a significant number of CNN-MOND infants of all GAs with HCs <10th and >90th percentiles were misclassified.

CONCLUSIONS: We developed recent gender-specific reference curves for HC at birth for singletons at 23 to 41 completed weeks’ GA, which included a large number of very premature infants, reflecting the current geotemporal Canadian population.

  • growth charts
  • fetal growth
  • microcephaly
  • macrocephaly
  • preterm birth
  • birth weight
  • head circumference
  • reference curves
  • brain growth
  • Abbreviations:
    AHC —
    appropriate head circumference
    CNN —
    Canadian Neonatal Network database
    GA —
    gestational age (completed weeks)
    HC —
    head circumference
    LHC —
    large head circumference
    MOND —
    McGill Obstetric and Neonatal Database
    SHC —
    small head circumference
    • Accepted December 12, 2012.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 4
    1 Apr 2013
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    New Reference Curves for Head Circumference at Birth, by Gestational Age
    Alexandre Barbier, Ariane Boivin, Woojin Yoon, Danielle Vallerand, Robert W. Platt, François Audibert, Keith J. Barrington, Prakesh S. Shah, Anne Monique Nuyt, the Canadian Neonatal Network
    Pediatrics Apr 2013, 131 (4) e1158-e1167; DOI: 10.1542/peds.2011-3846

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    New Reference Curves for Head Circumference at Birth, by Gestational Age
    Alexandre Barbier, Ariane Boivin, Woojin Yoon, Danielle Vallerand, Robert W. Platt, François Audibert, Keith J. Barrington, Prakesh S. Shah, Anne Monique Nuyt, the Canadian Neonatal Network
    Pediatrics Apr 2013, 131 (4) e1158-e1167; DOI: 10.1542/peds.2011-3846
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    • Fetus/Newborn Infant
      • Fetus/Newborn Infant
      • Neonatology
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      • Developmental/Behavioral Pediatrics
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    Keywords

    • growth charts
    • fetal growth
    • microcephaly
    • macrocephaly
    • preterm birth
    • birth weight
    • head circumference
    • reference curves
    • brain growth
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