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DOI: 10.1055/s-0029-1241738
Anterior Fontanel Size in Term and Late Preterm Hispanic Neonates: Description of Normative Values and an Alternative Measurement Method
Publication History
Publication Date:
12 October 2009 (online)
ABSTRACT
We sought to determine anterior fontanel size (AFS) in Hispanic neonates and to compare two methods of measurement. The traditional method (TRAD) was defined as the sum of the longitudinal and transverse dimensions, divided by 2. Diagonal measurements (DIAG) were obtained between the estimated midpoints of the edges of the frontal and parietal bones, and the sum was divided by 2. Interobserver reliability was assessed in a subset of the study population. One hundred seventy neonates with gestational age 38.9 ± 1.5 weeks were studied at a median age of 32 hours. Measurements by TRAD and DIAG (mean ± standard deviation) were 22.5 ± 7.9 mm and 20.9 ± 6.7 mm, respectively (p = 0.12). AFS was greater in males and in neonates whose mothers had longer duration of labor. Interobserver reliability was excellent for both methods. This study provides normative data for AFS using two methods in Hispanic neonates. A modest trend toward less variability with the DIAG method was noted. Male gender and longer duration of labor were associated with larger AFS.
KEYWORDS
Anterior fontanel - Hispanic - neonates - normative measurements
REFERENCES
- 1 Sundaresan M, Wright M, Price A B. Anatomy and development of the fontanelle. Arch Dis Child. 1990; 65(4 Spec No) 386-387
- 2 Popich G A, Smith D W. Fontanels: range of normal size. J Pediatr. 1972; 80 749-752
- 3 Duc G, Largo R H. Anterior fontanel: size and closure in term and preterm infants. Pediatrics. 1986; 78 904-908
- 4 Chang B F, Hung K L. Measurements of anterior fontanels [in Chinese]. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1990; 31 307-312
- 5 Adeyemo A A, Omotade O O. Variation in fontanelle size with gestational age. Early Hum Dev. 1999; 54 207-214
- 6 Faix R G. Fontanelle size in black and white term newborn infants. J Pediatr. 1982; 100 304-306
- 7 Mathur S, Kumar R, Mathur G P, Singh V K, Gupta V, Tripathi V N. Anterior fontanel size. Indian Pediatr. 1994; 31 161-164
- 8 Kiesler J, Ricer R. The abnormal fontanel. Am Fam Physician. 2003; 67 2547-2552
- 9 Scammon R, Adair F. The geometric relationships of the frontal fontanelle in infancy. Anat Rec. 1930; 46 349-363
- 10 Davies D P, Ansari B M, Cooke T J. Anterior fontanelle size in the neonate. Arch Dis Child. 1975; 50 81-83
- 11 Ballard J L, Khoury J C, Wedig K, Wang L, Eilers-Walsman B L, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991; 119 417-423
- 12 Portney L, Watkins M. Foundations of Clinical Research: Applications to Practice. 2nd ed. Upper Saddle River, NJ; 2000
Dr. Gregory L Jackson
5323 Harry Hines Blvd
Dept. of Pediatrics, Dallas, TX 75390-9063
Email: greg.jackson@utsouthwestern.edu