Objectives To assess the association of head circumference (HC) <10th percentile at birth and discharge from the neonatal intensive care unit (NICU) with neurodevelopment in very preterm (24–32 weeks’ gestational age) neonates, and to compare the association of HC and total cerebral volume (TCV) with neurodevelopmental outcomes. Design In a prospective cohort, semiautomatically segmented TCV and manually segmented white matter injury (WMI) volumes were obtained. Multivariable regressions were used to study the association of HC and TCV with neurodevelopmental outcomes, accounting for birth gestational age, WMI and postnatal illness. Setting Participants born in 2006–2013 at British Columbia Women’s Hospital were recruited. Patients 168 neonates had HC measurements at birth and discharge and MRI at term-equivalent age (TEA). 143 children were assessed at 4.5 years. Main outcome measures Motor, cognitive and language outcomes at 4.5 years were assessed using the Movement Assessment Battery for Children Second Edition (M-ABC) and Wechsler Preschool and Primary Scale of Intelligence Third Edition Full Scale IQ (FSIQ) and Verbal IQ (VIQ). Results Small birth HC was associated with lower M-ABC and FSIQ scores. In children with small birth HC, small discharge HC was associated with lower M-ABC, FSIQ and VIQ scores, while normal HC at discharge was no longer associated with adverse outcomes. HC strongly correlated with TCV at TEA. TCV did not correlate with outcomes. Conclusions Small birth HC is associated with poorer neurodevelopment, independent of postnatal illness and WMI. Normalisation of HC during NICU care appears to moderate this risk. No data are available. Data from this study are only available to researchers of the study team approved by our research ethics boards.

中文翻译：

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早产儿的头围、总脑容量和神经发育

目的 评估出生时头围 (HC) < 10% 和从新生儿重症监护室 (NICU) 出院与极早产（24-32 周胎龄）新生儿神经发育的关系，并比较 HC 的相关性和具有神经发育结果的总脑容量（TCV）。设计 在一个前瞻性队列中，获得了半自动分割的 TCV 和手动分割的白质损伤 (WMI) 体积。多变量回归用于研究 HC 和 TCV 与神经发育结果的关联，包括出生胎龄、WMI 和产后疾病。环境 招募了 2006-2013 年在不列颠哥伦比亚妇女医院出生的参与者。患者 168 名新生儿在出生和出院时进行了 HC 测量，并在足月等效年龄 (TEA) 进行了 MRI 检查。143 名儿童在 4.5 岁时接受了评估。主要结果测量 使用儿童运动评估电池第二版 (M-ABC) 和韦克斯勒学前和初级智力量表第三版全量表智商 (FSIQ) 和语言智商 (VIQ) 评估 4.5 岁时的运动、认知和语言结果. 结果 小出生 HC 与较低的 M-ABC 和 FSIQ 评分相关。在小出生 HC 的儿童中，小出院 HC 与较低的 M-ABC、FSIQ 和 VIQ 评分相关，而出院时的正常 HC 不再与不良结果相关。HC 与 TEA 的 TCV 密切相关。TCV 与结果无关。结论 小出生 HC 与较差的神经发育相关，与产后疾病和 WMI 无关。NICU 护理期间 HC 的正常化似乎可以缓和这种风险。没有可用的数据。