Andrea Šimić Klarić

Neuropsychological Development in Preschool Children Born With Asymmetrical Intrauterine Growth Restriction and Impact of Postnatal Head Growth

Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (P< .03) in motor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth–restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

Language development in preschool children born after asymmetrical intrauterine growth retardation

BACKGROUND After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. AIM The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. METHODS Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. RESULTS There were statistically significant differences (p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p < 0.05) in language comprehension and total expressive language. CONCLUSION Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language.

Timing of Head Circumference Measurement in Newborns

Aim. The objective of this study is to compare head circumferences (HCs) measured on the day of delivery and on the third day after delivery. Method. A total of 499 children born in the maternity department were recruited for the study. HC was measured in centimeters immediately after birth and on the third day after delivery. Results. There are statistically significant differences between HC at the time of birth and on the third day. Presentation and method of delivery were significantly associated with differences in HC. For presentation, we found that breech newborns more commonly have smaller HC on day 3 measurements (P = .001). For method of delivery, we found that cesarean sections also were more commonly associated with having smaller HC on day 3 measurement (P = .02). Conclusion. Measuring HC on the third day is more clinically valuable because much of the effects of molding and birth injuries will have subsided in most newborns.Aim. The objective of this study is to compare head circumferences (HCs) measured on the day of delivery and on the third day after delivery. Method. A total of 499 children born in the maternity department were recruited for the study. HC was measured in centimeters immediately after birth and on the third day after delivery. Results. There are statistically significant differences between HC at the time of birth and on the third day. Presentation and method of delivery were significantly associated with differences in HC. For presentation, we found that breech newborns more commonly have smaller HC on day 3 measurements (P = .001). For method of delivery, we found that cesarean sections also were more commonly associated with having smaller HC on day 3 measurement (P = .02). Conclusion. Measuring HC on the third day is more clinically valuable because much of the effects of molding and birth injuries will have subsided in most newborns.

Language Recovery After Acute Intracerebral Hematoma in Temporoparietal Region

Arteriovenous malformations are the most common cause of spontaneous intracerebral hemorrhages in older children. Intracerebral hematoma can cause serious lasting neurologic, cognitive, and language deficits, or even possible death. We present the case of a 16-year-old boy who had language impairments after suffering a large hemorrhagic stroke in the left temporoparietal region. All language components, verbal and nonverbal communication, reading, and writing, were found to be affected. These impairments were expected as they are characteristic of the location of the hematoma. After a year of speech language rehabilitation, there was an almost complete recovery of language skills. Quick diagnosis and adequate therapeutic interventions are important to diminish the influence of intracerebral hemorrhage on cognitive and language functions in children.