Background & Aims: The growth and development of infancy is vital to health and the quality of life throughout a person's life. On the other hand, motor and cognitive development during infancy will have a great impact on the performance of individuals during their school years and also on their success rate in their future career. One of the indicators of the intrauterine development of the fetus is the size of the head circumference at birth, which usually together with the weight and height of the baby, provides useful information about the intrauterine growth of the fetus and how to care for the mother during pregnancy. Head circumference is also a sensitive anthropometric indicator of prolonged malnutrition in infancy, so clinicians use head circumference as a measure of stunting. Head circumference is one of the cheap, simple, safe, economical and reliable indicators to evaluate the brain development and developmental status of babies. The accuracy of the measurement of this index can be strongly influenced by the expertise of the evaluators, which the employees of the primary health care departments have acquired the necessary expertise in this field. Interestingly, three very important anomalies, microcephaly and macrocephaly and hydrocephaly, can be easily assessed by evaluating the head circumference. Genetics and biological mechanisms are related to brain development, so determining head circumference growth in early childhood can play an important role in predicting abnormalities. Considering the importance of head circumference in evaluating a child's growth status, determining the influencing factors on this index can be very important. As a result, this study was conducted in order to evaluate the level of awareness of mothers regarding the value of head circumference at birth compared the weight and height of children admitted to Imam Khomeini Hospital in Ilam during the first six months of 2021-2022.
Methods: This retrospective study was conducted after obtaining the code of ethics from Medical University of Ilam and coordinating with the hospital management and security on the files of children admitted to Imam Khomeini Hospital in Ilam during the first 6 months of 2021-2022. The inclusion criteria included children born in 2017 and later, the files of children hospitalized in the first 6 months of 2021, the absence of developmental disorders, disabilities, and the absence of infectious diseases in children, and the exclusion criteria for incomplete files. According to the conditions of entering the study; 317 cases were included in the study by census. In this study, a researcher-made questionnaire was used to collect information, which included demographic variables such as mother's age, child's age, place of residence, gender, Mother's awareness of the value of head circumference at birth, child's height and weight, and child's birth rank. In taking the history, information was obtained without referring to the growth and vaccination card and only based on the mother's memory. The collected data was analyzed using SPSS 24 (IBM Corp, Armonk, New York) software at a significance level of 0.05 5 (confidence interval was 95%). Descriptive statistics of mean and standard deviation were used for quantitative variables and frequency and percentage were used for qualitative variables. Also, in order to determine the relationship between the level of awareness with the mother's age, weight and height of the child, independent t-test, the relationship of the mother's awareness with the place of residence and birth rank, using the chi-square test, and to evaluate the relationship between the delinquent variables and head circumference, multiple linear regression was used. became.
Results: This study was conducted on 317 hospitalized children with an average age of 24.92±16.77 months. The average age of mothers at delivery in this study was 29.87 ± 5.99 years. Based on the results of the study, 50.2% (159 people) were boys and 49.8% (158 people) were girls. The majority of children (33.4%) were in the age group of one year and less than one year. 5-year-old children in this study had the lowest frequency among the age group with 10.4% (33 people). The average head circumference at birth in the studied children was 34.11±1.43 cm, which was 34.00±0.70 cm in boys and 33.00±0.57 cm in girls. The average height in children was 49.88 ± 3.45 cm. Also, the average weight of children at birth was 3.066±0.46 kg. The results showed that 86 (27.1%) mothers were aware of the head circumference size of their children and 213 (72.9%) were not sufficiently aware of the head circumference size. The results of the independent t-test showed that the average height and weight of children in mothers who were aware of the value of head circumference was higher compared to mothers who were not aware, and a significant relationship was found between the value of head circumference compared to children's height and weight (p<0.05). The average age of mothers who were not aware of head circumference size was 30 years and among mothers who were aware of it was 28 years. The results of the independent t-test showed that mothers' awareness of children's head circumference has significantly decreased with increasing age (p=0.02). The level of awareness of urban mothers about the head size of their children at birth was higher than that of rural mothers, and this relationship was found to be significant based on the chi-square test (p=0.001). The results of the study showed that the higher the birth rank of the child, the lower the awareness of mothers. The results of chi-square test show that mothers' awareness of children's head circumference decreases significantly with increasing children's birth rank (p=0.01).
Multiple linear regression showed that there is a direct relationship between gender and head circumference (p=0.004), so that by removing the effect of other variables, head circumference in boys was 1 cm more than girls. Also, a direct relationship between weight and height of the baby with head circumference was obtained (p<0.05).
Conclusion: The results showed that mothers' awareness about the value of children's head circumference was moderate and this awareness decreases with age. Therefore, the determination of head circumference growth in early childhood can play an important role in predicting abnormalities; It is necessary to give necessary training to mothers in the field of children's height, weight and head circumference by health care workers during pregnancy care.