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Thursday, April 17, 2014
Newborn and Infant Care
Small head circumference & brain damage, etc
We are considering the referral of a baby girl from Korea. Our adoption agency has classified her as healthy, but our international adopton specialist was VERY concerned about her small head circumference.
She was full term at 40 weeks, normal vaginal delivery. Apgars of 7 & 9. Her birth weight was 5lbs. 5 oz. , Length was 19.6 in. Head Circ: 12.75inch 2 months weight: 11.0lbs Length: 20.86in Head circ: 14.17 She is now almost 4 months old weighs 13.2lbs. Length: 22.4 inches, but her head circumference: 14.56
The Dr. termed her as having microcephaly - should we be concerned? We are considerig turning down this referral since we are not able to care for a special needs child, but it looks to us like she is growing consistently.
We have asked for a 2nd opinion from another specialist, but are trying to gather as many opinions and thoughts (and resources, and info) as possible.
Thank you VERY much for your help!
Microcephaly may be caused by several factors:
- Familial: benign or associated with decreased intelligence, possible seizures and/or hyperactivity
- Toxic/metabolic factors: radiation, drug/alcohol/tobacco use in pregnancy, etc.
- Infectious: Maternal rubella, mumps, cytomegalovirus, toxoplasmosis, syphilis, HIV, etc.
- Inductive-migrational disorders: agyria, polymicrogyria, lissencephaly, schizencephaly, chromosomal disorders (trisomies, etc.), nonchromosomal disorders (Cornelia de Lange, Smith Lemli, Optiz)
- Vascular: asphyxia, placental infarction, septic shock
- Metabolic: maternal uremia or diabetes
Out of these possible causes, benign familial microcephaly is the only cause I could locate that is not definitely associated with a child that would require special medical, social, and educational services.
Source: Dershewitz, R.A. (Ed.). (1999). Ambulatory pediatric care (3rd ed.). Philadelphia: Lippincott-Raven. P 764-766.
Sarah Sauntry, RN, MS, CPNP-PC
Assistant Professor of Clinical Nursing
College of Nursing
University of Cincinnati