Proportionality of small-for-gestational age babies at birth: Perinatal associations and postnatal sequelae

Head and chest circumference and crown-rump length measurements were obtained for 413 small-for-gestational age (SGA) infants at birth; and head-chest, head-crown-rump and chest-crown rump ratios derived. There was an inverse correlation between head-chest ratios and gestational age, and boys had higher ratios than girls. First-born infants, and those whose mothers had pre-eclampsia had higher ratios than the rest, and higher ratios were associated with instrumental delivery. Higher ratios were also found for girls (but not boys) born to women of above average weight, and those who suffered birth asphyxia or other problems in the neonatal period. When adjustment was made for confounding between variables gestational age and sex were the only factors making a significant contribution to the variance in head-chest ratios at birth. SGA babies with relatively high head-chest ratios at birth grew faster than those with lower ratios during the first 6 mth of life. Girls with above-average ratios were heavier and had larger heads at the age of 7 yr, but no differences were found for either sex in any aspect of developmental ability at 7 yr associated with head-chest ratios at birth.