White Matter Damage in 4,725 Term-Born Infants Is Determined by Head Circumference at Birth: The Missing Link
Table 2
Odds ratios (OR, z-score bands) of white matter damage (WMD) assessed by cranial ultrasound according to anthropomorphic measurements in 4,725 term-born neonates at 37–43 weeks’ gestation. Please note that only head circumference (HC) showed a close relation to the risk of white matter damage over all z-score bands in that the odds ratios were significantly different in the <10%, 10 to <25%, 75 to <90%, and ≥90% z-score bands as compared with the reference (25 to <75%). And also note that the morphometric index (MMI) reflects the increased risk of white matter damage <10% and ≥90% centiles and is calculated as follows: MMI = (z-scoreWeight (centile) + z-scoreLength (centile) + z-scoreHC (centile) + z-scoreWeight/Length-ratio (centile) + z-score (3.1168–0.12797∗HC (centile) + 0.0014741∗HC2 (centile)))/5.
z-score bands (equivalent centiles)
Measurement
n Newborns screened
n WMD (%)
<−1.28 (<10%)
n
n WMD (%)
−1.28 to <−0.67 (10 to <25%)
n
n WMD (%)
−0.67 to <0.67 (25 to <75%)
n
n WMD (%)
0.67 to <1.28 (75 to <90%)
n
n WMD (%)
≥1.28 (≥90%)
n
n WMD (%)
OR (CI)
OR (CI)
OR
OR (CI)
OR (CI)
Weight (g)
4,725
61 (1.3)
2.96 (1.51–5.80)
479
14 (2.9)
0.001
1.25 (0.58–2.71)
717
9 (1.3)
0.572
Reference
2,284
23 (1.0)
1.11 (0.48–2.60)
772
7 (0.9)
0.807
0.59 (0.26–1.33)
473
8 (1.7)
0.199
Length (cm)
4,725
61 (1.3)
2.70 (1.16–6.28)
257
8 (3.1)
0.016
1.15 (0.60–2.19)
1,413
19 (1.4)
0.680
Reference
1,532
18 (1.2)
1.28 (0.59–2.77)
1,082
10 (0.9)
0.540
0.86 (0.34–2.19)
441
6 (1.4)
0.754
Head circumference (cm)
4,725
61 (1.3)
3.48 (1.35–8.98)
255
6 (2.4)
0.006
2.10 (1.09–4.04)
1,465
21 (1.4)
0.023
Reference
2,328
16 (0.7)
0.34 (0.15–0.76)
504
10 (2.0)
0.006
0.14 (0.06–0.34)
173
8 (4.6)
<0.001
Morphometric index
4,725
61 (1.3)
0.34 (0.14–0.86)
472
14 (3.0)
0.001
0.00 (0.00–4.11)
709
5 (0.7)
0.412
Reference
2,362
26 (1.1)
0.04 (0.00–39.74)
710
4 (0.6)
0.265
1.37 (0.29–6.34)
472
12 (2.5)
0.011
Weight-length ratio (W/L)
4,725
61 (1.3)
2.44 (1.18–5.03)
472
11 (2.3)
0.013
0.16 (0.78–3.32)
708
11 (1.6)
0.192
Reference
2,371
23 (1.0)
1.03 (0.44–2.41)
702
7 (1.1)
0.949
0.18 (0.02–2.04)
472
9 (1.9)
0.078
Ponderal index (100∗W/L3)
4,725
61 (1.3)
0.84 (0.32–2.17)
470
5 (1.1)
0.717
1.10 (0.54–2.27)
714
10 (1.4)
0.788
Reference
2,361
30 (1.3)
1.10 (0.54–2.27)
714
10 (1.4)
0.788
1.17 (0.51–2.69)
471
7 (1.5)
0.707
Reference value: z-score band −0.67 to <0.67 (25th to below 75th centile); All bold p values highlight OR (CI) that are significantly different from the reference; the level of significance is given by the probability of error (p).
