The Size of Anterior Fontanel in Neonates and Infants in Addis Ababa
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Date
2004-07
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Abstract
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
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Keywords
Anterior fontanel; Anterior-posterior dimension; Lateral dimension; Neonate and Infant