Pattern of head growth and nutritional status of microcephalic infants at early postnatal assessment in a low-income country

To determine the pattern of head growth and the early postnatal nutritional status of microcephalic infants in a low-income country. A cohort study in Lagos, Nigeria in which the head growth of full-term singletons within the first postnatal check-up at 6-8 weeks was evaluated using the latest World Health Organization (WHO)'s Child Growth Standards (WHO-CGS) for head circumference. Nutritional status of microcephalic infants at follow-up was also determined after adjustments for potential confounders. Of the 452 infants (male: 227) enrolled, microcephalic infants were 32 (7.1%) at birth and 34 (7.5%) at follow-up. However, while 401 (88.7%) remained normocephalic and 15 (3.3%) remained microcephalic at follow-up, 19 (4.2%) became microcephalic and 17 (3.8%) became normocephalic. Microcephalic infants were significantly underweight (P < 0.001), stunted (P < 0.001) and wasted (P < 0.001) at follow-up. Regardless of their status at birth, microcephalic infants at 6-8 weeks are likely to be undernourished by all nutritional indices suggesting that head circumference may serve as a complementary or default screening tool for early detection of undernourished infants in resource-constrained settings.