Acquired microcephaly after low Apgar score in Zimbabwe

Serial head circumference measurements were made on 165 African babies born with a 5 min Apgar score of 5 or less. Measurements were taken at birth an d at 4, 9, and 12 months of age. In the majority of infants the onset of mi crocephaly could be diagnosed as early as 4 months of age. Twenty-five of t he 142 infants were microcephalic at 1 year. Neurological development was i mpaired in 19 of the 25 (76 per cent) microcephalic infants and in 18 of th e 117 (15 per cent) normocephalic infants. Fourteen of the 16 (88 per cent) infants with severe quadriplegia developed microcephaly before the age of 4 months. A decreased rate of head growth during the first 4 months of life in African infants born with a low Apgar score correlates closely with the development of microcephaly. Infants with an acquired microcephaly have a high probability of developing neurologic impairment by the age of 1 year. Serial head circumference measurement in low Apgar score babies in developi ng countries is an easy, simple, and inexpensive method to detect microceph aly.