RELATIONSHIP BETWEEN HEAD GROWTH AND NEURODEVELOPMENTAL OUTCOME OF MALAYSIAN VERY-LOW-BIRTH-WEIGHT INFANTS DURING THE 1ST YEAR OF LIFE

A prospective study was carried out to (i) compare head growth pattern s of 103 very low birthweight (VLBW, < 1500 g) Malaysian infants and 9 8 normal birthweight (NBW, 2500-<4500 g) controls during the Ist year of life; and Cii) examine the relationship between neurodevelopmental outcome at 1 year of age and occipito-frontal head circumferences (OFC ) at birth and at 1 year of age in VLBW babies. When compared with tho se of NEW infants at birth, mid-infancy and I year of age, the mean OF C ratios (observed/expected OFC at 50th percentile) of VLBW infants we re significantly lower (P < 0.001). Small-for-gestational-age (SGA) VL BW babies had significantly lower mean OFC ratios than their appropria te-for-gestational-age (AGA) VLBW counterparts at birth (p < 0.001), b ut this difference was no longer seen at mid-infancy or at 1 year of a ge. Logistic regression analysis showed that abnormal late neonatal cr anial ultrasound findings (odds ratio 8.5, 95% confidence interval 4.1 2-22.07; p < 0.001) and each additional day of oxygen therapy (odds ra tio 1.15, 95% confidence interval 1.00-4.45; p = 0.045) were significa nt risk factors associated with neurodevelopmental disability at I yea r of age, while mean OFC ratios at birth or at 1 year of age were not. Poor postnatal head growth per se did not predict disability, but pro bably reflected the consequences of ''brain injury'' as evidenced by a bnormal brain scans.