Biparietal diameter: an alternative measure of head growth in the low-birthweight infant

Tirosh, Emanuel; Weinger, M. A.; Berger, Anna; Cohen, Amy

doi:10.3109/03091909209021964

Cited by 2 publications

(1 citation statement)

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“…Measurement protocols also differ even when rigorously standardized-the U.S. Centers for Disease Control and Prevention's recommendation for the Zika epidemic was to measure three times and take the largest measurement [9], while NHANES requires only a single measure [15]. Because of the limited reliability, other methods of assessing HC have been sought, including digital calipers that limit stretching [33], and use of biparietal diameter instead of circumference [34]; however, limited availability and required maintenance of appropriate instruments, as well as lack of sex and GA standards for biparietal diameter in most populations might be challenges for widespread adoption of these methods. As training on the SECA tapes was not successful in correcting issues identified with the measurement of head circumference in hospital settings, it is probable that precise head circumference measurement in the delivery room is an unrealistic goal.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

et al. 2020

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Worldwide recognition of the Zika virus outbreak in the Americas was triggered by an unexplained increase in the frequency of microcephaly. While severe microcephaly is readily identifiable at birth, diagnosing less severe cases requires comparison of head circumference (HC) measurement to a growth chart. We examine measured values of HC and digit preference in those values, and, by extension, the prevalence of microcephaly at birth in two data sources: a research study in Honduras and routine surveillance data in Uruguay. The Zika in Pregnancy in Honduras study enrolled pregnant women prenatally and followed them until delivery. Head circumference was measured with insertion tapes (SECA 212), and instructions including consistent placement of the tape and a request to record HC to the millimeter were posted where newborns were examined. Three indicators of microcephaly were calculated: (1) HC more than 2 standard deviations (SD) below the mean, (2) HC more than 3 SD below the mean (referred to as “severe microcephaly”) and (3) HC less than the 3rd percentile for sex and gestational age, using the INTERGROWTH-21st growth standards. We compared these results from those from a previous analysis of surveillance HC data from the Uruguay Perinatal Information System (Sistema Informático Perinatal (SIP). Valid data on HC were available on 579 infants, 578 with gestational age data. Nine babies (1.56%, 95% CI 0.71–2.93) had HC < 2SD, including two (0.35%, 95% CI 0.04–1.24) with HC < 3SD, and 11 (1.9%, 95% CI, 0.79–3.02) were below the 3rd percentile. The distribution of HC showed strong digit preference: 72% of measures were to the whole centimeter (cm) and 19% to the half-cm. Training and use of insertion tapes had little effect on digit preference, nor were overall HC curves sufficient to detect an increase in microcephaly during the Zika epidemic in Honduras. When microcephaly prevalence needs to be carefully analyzed, such as during the Zika epidemic, researchers may need to interpret HC data with caution.

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Section: Discussionmentioning

confidence: 99%