The Size of Anterior Fontanel in Neonates and Infants in Addis Ababa

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The size and the time of closure of anterior fontanel (AF) is often used in the diagnosis of disorders like altered skeletal morphogenesis, increased intracranial pressure, hormonal disorders and others. In order to properly utilize AF size in the diagnosis of different disorders, it is necessary to establish a normal range of AF sizes related to age. Racial differences in the size of AF and its time of closure has been reported and there are many countries with their own national standard. To my knowledge, there is no study done to determine the AF size and its time of closure in Ethiopian neonates and infants. The present study aims to establish mean AF size for Addis Ababa (A.A.) neonates and infants at the ages of 3, 46, 76, 106 and 270 days. The study is a cross sectional design carried out from January 2003 to December 2003 in A.A. and the study sites chosen were Tikur Anebessa Specialized Hospital, Zewditu Memorial Hospital, Tekele Haymanot and Wereda 23 Health Centers. The subjects were 687 neonates and infants, of which 363 were males and 324 were females. All cases fulfilling the inclusion criteria were included in a row until the targeted sample size was attained. The AF size, body weight, body length and head circumference were measured. When measuring AF size, first the four vertices were identified. After marking the vertices with washable ink, the marks were transferred on a sheet of paper. From the marks transferred on the sheet of paper, the anterior-posterior and the lateral dimensions were measured. The mean of the anterior-posterior and the lateral dimensions was taken as AF size. The mean AF size progressively decreased with age except at 106 days measurement which showed increase over the 76 days measurement. In all ages considered, no significant difference (p>0.05) was found in neonates and infants of different gender, birth order, gestational age and economic status. AF closure was observed beginning at the age of 76 days (0.8%) and the percent of closure increased with age. In Infants at the age of 270 days, 39.6% of them had closed AF. There were no significant (p>0.05) correlations between AF size and body weight, body length and head circumference while there was negative significant (p<0.05) correlation between AF size and age. The result of the present study shows congruence with the study on Nigerian and Indian neonates but disagrees with the study done on Arab, Israeli, China and white neonates and infants. Further study in different parts of Ethiopia is recommended to establish a national age- related standard for AF size and its time of closure. Key words: Anterior fontanel, Anterior-posterior dimension, lateral dimension, Neonate and infant



Anterior fontanel; Anterior-posterior dimension; Lateral dimension; Neonate and Infant