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Fetal head circumference growth in children with specific language impairment
  1. Andrew J O Whitehouse1,2,
  2. Stephen R Zubrick3,
  3. Eve Blair1,
  4. John P Newnham4,
  5. Martha Hickey5
  1. 1Centre for Child Health Research, University of Western Australia, Perth, Australia
  2. 2Neurocognitive Development Unit, School of Psychology, University of Western Australia, Perth, Australia
  3. 3Centre for Developmental Health, Curtin University of Technology, Perth, Australia
  4. 4School of Women's and Infants' Health, University of Western Australia, Perth, Australia
  5. 5Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
  1. Correspondence to Dr Andrew Whitehouse, Telethon Institute for Child Health Research, Centre for Child Health Research, PO Box 855, University of Western Australia, West Perth 6872, Western Australia; awhitehouse{at}


Objective To characterise fetal brain growth in children with specific language impairment (SLI).

Design A nested case–control study.

Setting Perth, Western Australia.

Participants Thirty children meeting criteria for SLI at age 10 years were individually matched with a typically developing comparison child on sex, non-verbal ability, fetal gestational age, maternal age at conception, smoking and alcohol intake during pregnancy.

Main outcome measures Occipitofrontal head circumference (HC) was measured using ultrasonography at approximately 18 weeks gestation. Femur length provided a measure of fetal length. Occipitofrontal HC was measured at birth and at the 1-year postnatal follow-up using a precise paper tape measure, while crown-heel length acted as an index of body length at both time points. Raw data were transformed to z-scores using reference norms.

Results The SLI group had a significantly smaller mean HC than the typically developing comparison children at birth, but there was no group difference at 18 weeks gestation or at the 1-year postnatal follow-up. Individual analyses found that 12 SLI children had an HC z-score less than −1 at birth, with three of these cases meeting criteria for microcephaly. There was no group difference in the indices of overall body size at any time point.

Conclusions Children with SLI are more likely to have a small HC at birth but not at 18 weeks gestation or infancy, suggesting growth asynchrony in brain development during the second half of pregnancy.

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  • Funding National Health and Medical Research Council (NHMRC), the Raine Medical Research Foundation, the Telethon Institute for Child Health Research, and the Women's and Infants' Research Foundation.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the King Edward Memorial Hospital (Perth, Western Australia) and Princess Margaret Hospital (Perth, Western Australia).

  • Provenance and peer review Not commissioned; externally peer reviewed.