Associations of head circumference trajectories and growth-sensitive periods during the first two years of life with adolescent cognitive, emotional and behavioral health: A birth cohort in rural western China

Abstract Purpose The associations of early-life head circumference (HC) with child cognition and emotional and behavioral health among generally healthy population remain unclear. We aimed to examine the associations of early-life HC trajectories with adolescent neurodevelopmental and mental health and to identify HC growth-sensitive period. MethodsWe conducted a prospective, community-based birth cohort in rural western China, and 745 adolescents aged 10-14 years were followed between June to December 2016. We repeatedly assessed child HC for eight times during the first two years of life, and adolescent cognitive and emotional and behavioral outcomes using Wechsler Intelligence Scale for Children and Youth Self-Report, respectively. We applied group-based trajectory modeling to identify HC trajectories and used conditional growth to derive sensitive periods. ResultsWe identified five distinct HC trajectories characterized as Start below average-then decrease (7.8% of the sample), Start below average-then increase (6.8%), Start average-then decrease (33.4%), Consistently average (37.9%), and Consistently above average (14.1%). Infants in the trajectory of consistently above average had higher cognitive scores at early adolescence as compared to those from suboptimal trajectories, with adjusted mean differences ranging from -2.84 to -8.99 points. The conditional gains show that the sensitive HC growth period appeared to be between 0-6 months. While we found null associations between HC measures and adolescent emotional and behavioral health.ConclusionsRoutine HC measurements especially during the first 6 months were recommended for monitoring child cognition but for mental health. Integrated prenatal and postnatal interventions should be pursued to promote child development.