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Head Growth and Intelligence from Birth to Adulthood in Very Preterm and Term Born Individuals

  • Julia Jaekel (a1) (a2), Christian Sorg (a3) (a4) (a5), Josef Baeuml (a3) (a4) (a5), Peter Bartmann (a6) and Dieter Wolke (a2) (a7)...


Objectives: The aim of this study was to investigate the effects of infant and toddler head growth on intelligence scores from early childhood to adulthood in very preterm (<32 weeks gestational age; VP) and/or very low birth weight (<1500 g; VLBW) and term born individuals. Methods: 203 VP/VLBW and 198 term comparisons were studied from birth to adulthood as part of the prospective geographically defined Bavarian Longitudinal Study (BLS). Head circumference was assessed at birth; 5, 20 months; and 4 years of age. Intelligence was assessed with standardized tests in childhood (6 and 8 years: K-ABC) and at 26 years (Wechsler Adult Intelligence Scale, WAIS). Structural equation modeling (SEM) was used to model the effect of head growth on IQ. Results: On average, VP/VLBW had lower head circumference at birth (27.61 cm vs. 35.11 cm, mean difference 7.49, 95% confidence interval [7.09–7.90]) and lower adult intelligence scores (88.98 vs. 102.54, mean difference 13.56 [10.59–16.53]) than term born comparison individuals. Head circumference at birth (e.g., total effect β=.48; p<.001 for adult IQ) and head growth in childhood predicted intelligence development from age 6 to 26 years in both VP/VLBW and term born individuals (70% of variance in adult IQ explained by full model). Effects of gestation and birth weight on intelligence were fully mediated by head circumference and growth. Conclusions: This longitudinal investigation from birth to adulthood indicates head growth as a proxy of brain development and intelligence. Repeated early head circumference assessment adds valuable information when screening for long-term neurocognitive risk. (JINS, 2019, 25, 48#x2013;56)

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Corresponding author

Correspondence and reprint requests to: Dieter Wolke, Department of Psychology, University of Warwick, Coventry CV4 7AL, UK. E-mail:


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Anderson, P.J., Treyvaud, K., Neil, J.J., Cheong, J.L.Y., Hunt, R.W., Thompson, D.K., … Inder, T.E. (2017). Associations of newborn brain magnetic resonance imaging with long-term neurodevelopmental impairments in very preterm children. The Journal of Pediatrics, 187, 5865. doi: 10.1016/j.jpeds.2017.04.059
Aslin, R.N., & Fiser, J. (2005). Methodological challenges for understanding cognitive development in infants. Trends in Cognitive Sciences, 9(3), 9298. doi: 10.1016/j.tics.2005.01.003
Ball, G., Boardman, J.P., Rueckert, D., Aljabar, P., Arichi, T., Merchant, N., … Counsell, S.J. (2012). The effect of preterm birth on thalamic and cortical development. Cerebral Cortex, 22, 10161024.
Bartholomeusz, H.H., Courchesne, E., & Karns, C.M. (2002). Relationship between head circumference and brain volume in healthy normal toddlers, children, and adults. Neuropediatrics, 33(5), 239241. doi: 10.1055/s-2002-36735
Bauer, A. (1988). Ein Verfahren zur Messung des fuer das Bildungsverhalten relevanten Sozial Status (BRSS) - ueberarbeitete Fassung. Frankfurt: Deutsches Institut fuer Internationale Paedagogische Forschung.
Bäuml, J.G., Daamen, M., Meng, C., Neitzel, J., Scheef, L., Jaekel, J., … Sorg, C. (2015). Correspondence between aberrant intrinsic network connectivity and gray matter volume in the ventral brain of preterm born adults. Cerebral Cortex, 25, 41354145. doi:10.1093/cercor/bhu133
Belfort, M.B., Anderson, P.J., Nowak, V.A., Lee, K.J., Molesworth, C., Thompson, D.K., … Inder, T.E. (2016). Breast milk feeding, brain development, and neurocognitive outcomes: A 7-year longitudinal study in infants born at less than 30 weeks’ gestation. The Journal of Pediatrics, 177, 133139.e131. doi: 10.1016/j.jpeds.2016.06.045
Benzies, K., Magill-Evans, J., Hayden, K., & Ballantyne, M. (2013). Key components of early intervention programs for preterm infants and their parents: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 13(Suppl. 1), S10.
Bornstein, M.H., Hahn, C.-S., & Wolke, D. (2013). Systems and cascades in cognitive development and academic achievement. Child Development, 84(7), 154162. doi:10.1111/j.1467-8624.2012.01849.x
Brandt, I. (1983). Griffiths Entwicklungsskalen (GES zur Beurteilung der Entwicklung in den ersten beiden Lebensjahren). Weinheim: Beltz.
Breeman, L.D., Jaekel, J., Baumann, N., Bartmann, P., & Wolke, D. (2015). Preterm cognitive function into adulthood. Pediatrics, 136(3), 415423. doi:10.1542/peds.2015-0608
Cheong, J.L., Anderson, P.J., Burnett, A.C., Roberts, G., Davis, N., Hickey, L., … Doyle, L.W. (2017). Changing neurodevelopment at 8 years in children born extremely preterm since the 1990s. Pediatrics, 139, pii: e201664086. doi:10.1542/peds.2016-4086
Cheong, J.L., Hunt, R.W., Anderson, P.J., Howard, K., Thompson, D.K., Wang, H.X., … Doyle, L.W. (2008). Head growth in preterm infants: Correlation with magnetic resonance imaging and neurodevelopmental outcome. Pediatrics, 121(6), e1534e1540. doi:10.1542/peds.2007-2671
Christmann, V., Roeleveld, N., Visser, R., Janssen, A.J.W.M., Reuser, J.J.C.M., van Goudoever, J.B., & van Heijst, A.F.J. (2017). The early postnatal nutritional intake of preterm infants affected neurodevelopmental outcomes differently in boys and girls at 24 months. Acta Paediatrica, 106(2), 242249. doi:10.1111/apa.13669
Cockerill, J., Uthaya, S., Doré, C.J., & Modi, N. (2006). Accelerated postnatal head growth follows preterm birth. Archives of Disease in Childhood - Fetal and Neonatal Edition, 91(3), F184F187. doi:10.1136/adc.2005.077818
Doyle, L.W., Anderson, P.J., Battin, M., Bowen, J.R., Brown, N., Callanan, C., … Woodward, L.J. (2014). Long term follow up of high risk children: Who, why and how? BMC Pediatrics, 14(1), 279. doi:10.1186/1471-2431-14-279
Edwards, A.D., Redshaw, M.E., Kennea, N., Rivero-Arias, O., Gonzales-Cinca, N., Nongena, P., … Counsell, S. (2018). Effect of MRI on preterm infants and their families: A randomised trial with nested diagnostic and economic evaluation. Archives of Disease in Childhood. Fetal and Neonatal Edition, 103(1), F15F21. doi:10.1136/archdischild-2017-313102
Eryigit Madzwamuse, S., Baumann, N., Jaekel, J., Bartmann, P., & Wolke, D. (2015). Neuro‐cognitive performance of very preterm or very low birth weight adults at 26 years. Journal of Child Psychology and Psychiatry, 56(8), 857864.
Fenton, T.R., & Kim, J.H. (2013). A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics, 13(1), 59. doi:10.1186/1471-2431-13-59
Gale, C.R., O’Callaghan, F.J., Bredow, M., & Martyn, C.N. (2006). The influence of head growth in fetal life, infancy, and childhood on intelligence at the ages of 4 and 8 years. Pediatrics, 118(4), 14861492. doi:10.1542/peds.2005-2629
Garcia-Alix, A., Saenz-de Pipaon, M., Martinez, M., Salas-Hernandez, S., & Quero, J. (2004). [Ability of neonatal head circumference to predict long-term neurodevelopmental outcome]. Revista de Neurologia, 39(6), 548554.
Hack, M., Taylor, H.G., Drotar, D., Schluchter, M., Cartar, L., Wilson-Costello, D., … Morrow, M. (2005). Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age. Pediatrics, 116(2), 333341. doi:10.1542/peds.2005-0173
Hille, E.T.M., Elbertse, L., Gravenhorst, J.B., Brand, R., & Verloove-Vanhorick, S.P. (2005). Nonresponse bias in a follow-up study of 19-year-old adolescents born as preterm infants. Pediatrics, 116, e662e666. doi:10.1542/peds.2005-0682
Hintz, S.R., Vohr, B.R., Bann, C.M., Taylor, H.G., Das, A., Gustafson, K.E., … Higgins, R.D. (2018). Preterm neuroimaging and school-age cognitive outcomes. Pediatrics. 142, pii: e20174058. doi:10.1542/peds.2017-4058
Holland, D., Chang, L., Ernst, T.M., Curran, M., Buchthal, S.D., Alicata, D., … Dale, A.M. (2014). Structural growth trajectories and rates of change in the first 3 months of infant brain development. JAMA Neurology, 71(10), 12661274. doi:10.1001/jamaneurol.2014.1638
Jaekel, J., Baumann, N., & Wolke, D. (2013). Effects of gestational age at birth on cognitive performance: A function of cognitive workload demands. PLoS One, 8(5), e65219. doi:10.1371/journal.pone.0065219
Jaekel, J., Schölmerich, A., Kassis, W., & Leyendecker, B. (2011). Parental bookreading as a resource for pre-schoolers´ cognitive skills in Turkish migrant and German non-migrant families. International Journal of Developmental Science, 5, 113.
James, H.E., Perszyk, A.A., MacGregor, T.L., & Aldana, P.R. (2015). The value of head circumference measurements after 36 months of age: A clinical report and review of practice patterns. Journal of Neurosurgery. Pediatrics, 16(2), 186194. doi:10.3171/2014.12.peds14251
Kapellou, O., Counsell, S.J., Kennea, N., Dyet, L., Saeed, N., Stark, J., … Edwards, A.D. (2006). Abnormal cortical development after premature birth shown by altered allometric scaling of brain growth. PLoS Med, 3(8), e265.
Keunen, K., van Elburg, R.M., van Bel, F., & Benders, M.J.N.L. (2015). Impact of nutrition on brain development and its neuroprotective implications following preterm birth. Pediatric Research, 77(1-2), 148155. doi:10.1038/pr.2014.171
Kidokoro, H., Anderson, P.J., Doyle, L.W., Woodward, L.J., Neil, J.J., & Inder, T.E. (2014). Brain injury and altered brain growth in preterm infants: Predictors and prognosis. Pediatrics, 134(2), e444e453. doi:10.1542/peds.2013-2336
Kiesler, J., & Ricer, R. (2003). The abnormal fontanel. American Family Physician, 67(12), 25472552.
Lange, N., Froimowitz, M.P., Bigler, E.D., & Lainhart, J.E. (2010). Associations between IQ, total and regional brain volumes and demography in a large normative sample of healthy children and adolescents. Developmental Neuropsychology, 35(3), 296317. doi:10.1080/87565641003696833
Li, G., Wang, L., Shi, F., Lyall, A.E., Lin, W., Gilmore, J.H., & Shen, D. (2014). Mapping longitudinal development of local cortical gyrification in infants from birth to 2 years of age. The Journal of Neuroscience, 34(12), 42284238. doi:10.1523/jneurosci.3976-13.2014
Lyall, A.E., Shi, F., Geng, X., Woolson, S., Li, G., Wang, L., … Gilmore, J.H. (2015). Dynamic development of regional cortical thickness and surface area in early childhood. Cerebral Cortex, 25(8), 22042212. doi:10.1093/cercor/bhu027
Makropoulos, A., Aljabar, P., Wright, R., Hüning, B., Merchant, N., Arichi, T., … Rueckert, D. (2016). Regional growth and atlasing of the developing human brain. NeuroImage, 125, 456478. doi:
Marioni, R.E., Davies, G., Hayward, C., Liewald, D., Kerr, S.M., Campbell, A., … Deary, I.J. (2014). Molecular genetic contributions to socioeconomic status and intelligence. Intelligence, 44, 2632. doi:
McCormick, M.C., Brooks-Gunn, J., Buka, S.L., Goldman, J., Yu, J., Salganik, M., … Casey, P.H. (2006). Early intervention in low birth weight premature infants: Results at 18 years of age for the Infant Health and Development Program. Pediatrics, 117(3), 771780.
Melchers, P., & Preuss, U. (1991). K-ABC: Kaufman Battery for Children: Deutschsprachige Fassung. Frankfurt, AM: Swets & Zeitlinger.
Melhuish, E.C. (2011). Preschool matters. Science, 333(6040), 299300. doi:10.1126/science.1209459
Meng, C., Bauml, J.G., Daamen, M., Jaekel, J., Neitzel, J., Scheef, L., … Sorg, C. (2016). Extensive and interrelated subcortical white and gray matter alterations in preterm-born adults. Brain Structure & Function, 221(4), 21092121. doi:10.1007/s00429-015-1032-9
Milgrom, J., Newnham, C., Anderson, P.J., Doyle, L.W., Gemmill, A.W., Lee, K., … Inder, T. (2010). Early sensitivity training for parents of preterm infants: Impact on the developing brain. Pediatric Research, 67(3), 330335.
Moore, T., Hennessy, E.M., Myles, J., Johnson, S., Draper, E.S., Costeloe, K.L., & Marlow, N. (2012). Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: The EPICure studies. BMJ, 345, e7961. doi:10.1136/bmj.e7961
Padilla, N., Alexandrou, G., Blennow, M., Lagercrantz, H., & Ådén, U. (2015). Brain growth gains and losses in extremely preterm infants at term. Cerebral Cortex, 25(7), 18971905. doi:10.1093/cercor/bht431
Parker, J., Mitchell, A., Kalpakidou, A., Walshe, M., Jung, H.-Y., Nosarti, C., … Allin, M. (2008). Cerebellar growth and behavioural & neuropsychological outcome in preterm adolescents. Brain, 131, 13441351.
Pineda, R.G., Neil, J., Dierker, D., Smyser, C.D., Wallendorf, M., Kidokoro, H., … Inder, T. (2014). Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. The Journal of Pediatrics, 164(1), 5260.e52. doi:
Räikkönen, K., Forsén, T., Henriksson, M., Kajantie, E., Heinonen, K., Pesonen, A.-K., … Eriksson, J.G. (2009). Growth trajectories and intellectual abilities in young adulthood: The Helsinki Birth Cohort Study. American Journal of Epidemiology, 170(4), 447455. doi:10.1093/aje/kwp132
Sameroff, A.J., Seifer, R., Barocas, R., Zax, M., & Greenspan, S. (1987). Intelligence quotient scores of 4-year-old children: Social-environmental risk factors. Pediatrics, 79(3), 343350.
Sammallahti, S., Heinonen, K., Andersson, S., Lahti, M., Pirkola, S., Lahti, J., … Raikkonen, K. (2017). Growth after late-preterm birth and adult cognitive, academic, and mental health outcomes. Pediatric Research, 81, 767774. doi:10.1038/pr.2016.276
Sammallahti, S., Pyhala, R., Lahti, M., Lahti, J., Pesonen, A.K., Heinonen, K., … Raikkonen, K. (2014). Infant growth after preterm birth and neurocognitive abilities in young adulthood. The Journal of Pediatrics, 165(6), 11091115.e1103. doi:10.1016/j.jpeds.2014.08.028
Schneider, W., Niklas, F., & Schmiedeler, S. (2014). Intellectual development from early childhood to early adulthood: The impact of early IQ differences on stability and change over time. Learning and Individual Differences, 32, 156162. doi: 10.1016/j.lindif.2014.02.001
Silventoinen, K., Iacono, W.G., Krueger, R., & McGue, M. (2012). Genetic and environmental contributions to the association between anthropometric measures and IQ: A study of Minnesota twins at age 11 and 17. Behavior Genetics, 42(3), 393401. doi:10.1007/s10519-011-9521-y
Usami, S., Hayes, T., & McArdle, J. (2017). Fitting structural equation model trees and latent growth curve mixture models in longitudinal designs: The influence of model misspecification. Structural Equation Modeling: A Multidisciplinary Journal, 24(4), 585598. doi:10.1080/10705511.2016.1266267
Von Aster, M., Neubauer, A., & Horn, R. (2006). Wechsler Intelligenztest für Erwachsene (WIE) [Wechsler Adult Intelligence Scale (WAIS III)]. Frankfurt/Main, Germany: Harcourt Test Services.
WHO. (2007). WHO Child Growth Standards: Head circumference-for-age, arm circumference-for-age, triceps skinfold-for-age and subscapular skinfold-for-age: Methods and development. Retrieved from
Wilson-Ching, M., Pascoe, L., Doyle, L.W., & Anderson, P.J. (2014). Effects of correcting for prematurity on cognitive test scores in childhood. Journal of Paediatrics and Child Health, 50(3), 182188. doi:doi:10.1111/jpc.12475
Wolke, D., Jaekel, J., Hall, J., & Baumann, N. (2013). Effects of sensitive parenting on the academic resilience of very preterm and very low birth weight adolescents. Journal of Adolescent Health, 53(5), 642647.
Wolke, D., & Meyer, R. (1999). Cognitive status, language attainment, and prereading skills of 6-year-old very preterm children and their peers: The Bavarian Longitudinal Study. Developmental Medicine & Child Neurology, 41, 94109.
Wolke, D., Strauss, V.Y.-C., Johnson, S., Gilmore, C., Marlow, N., & Jaekel, J. (2015). Universal gestational age effects on cognitive and basic mathematic processing: 2 cohorts in 2 countries. The Journal of Pediatrics, 166(6), 14101416. e1412.
Wright, C.M., & Emond, A. (2015). Head growth and neurocognitive outcomes. Pediatrics, 135(6), e1393e1398. doi:10.1542/peds.2014-3172
Zander, J., Holzmann, K., & Selbmann, H.K. (1989). Materialien aus der bayerischen Perinatalerhebung zur Problematik der Sectiofrequenz [Data from the Bavarian perinatal survey on the problem of the incidence of cesarean section]. Geburtshilfe Frauenheilkunde, 49(4), 328336.


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Head Growth and Intelligence from Birth to Adulthood in Very Preterm and Term Born Individuals

  • Julia Jaekel (a1) (a2), Christian Sorg (a3) (a4) (a5), Josef Baeuml (a3) (a4) (a5), Peter Bartmann (a6) and Dieter Wolke (a2) (a7)...


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