Figures & Tables
Figures
- FIGURE 1
Box Plot With Whiskers of Estimated Gestational Agea
Note: Median gestational age is 38.7 weeks, and the interquartile range is 37.4 to 39.9 weeks.
a Gestational age was estimated by centering an infant's height at a z-score of zero on gender-adjusted Fenton growth curves.
- FIGURE 2
Measured Head Circumference and Z-Score for All Infants by Month of Birth
Tables
Origin of Case Definition Microcephaly Case Definition Brazil MOH 1 Term: OFC ≤33.0 cm for all infants
Preterm: OFC ≤3rd percentile Fenton GC adjusted for GA and genderBrazil MOH 2 Term: OFC ≤32.0 cm for all infants
Preterm: OFC ≤3rd percentile Fenton GC adjusted for GA and genderPAHO 1 Term: OFC <−2 SD WHO GC for males (<31.9 cm) and females (<31.5 cm)
Preterm: OFC <−2 SD Fenton GC adjusted for GA and genderPAHO 2 Term: OFC <3rd percentile WHO GC for males (<32.0 cm) and females (31.6 cm)
Preterm: OFC <3rd percentile Fenton GC adjusted for GA and genderWHO 1 Unknown GA, suspected term: OFC <−2 SD WHO GC
0–6 days: males: <31.9 cm; females: <31.5 cm
7–13 days: males: <32.7 cm; females: <32.2 cmWHO 2 Unknown GA, suspected term: OFC <3rd percentile WHO GC
0–6 days: males: <32.0 cm; females: <31.6 cm
7–13 days: males: <32.8 cm; females: <32.4 cmWHO 3 Unknown GA, suspected term: OFC <−3 SD WHO GCa
0–6 days: males: <30.7 cm; females: <30.3 cm
7–13 days: males: <31.5 cm; females: <31.1 cmFenton 1 All infants: <−2 SD Fenton GC adjusted for gender and estimated GA Fenton 2 All infants: <3rd percentile Fenton GC adjusted for gender and estimated GA Fenton 3 All infants: <−3 SD Fenton GC adjusted for gender and estimated GAa Abbreviations: GA, gestational age; GC, growth curve; MOH, Ministry of Health; OFC, occipital frontal head circumference; PAHO, Pan American Health Organization; SD, standard deviation; WHO, World Health Organization.
↵a <-3 SD defines severe microcephaly.
- TABLE 2.
Characteristics of Neonates Born Between August 1, 2014, and March 31, 2016, in Rural Guatemala (N=296)
Characteristic No. (%) Gender Male 143 (48.3) Female 153 (51.7) Birth year 2014 20 (6.8) 2015 214 (72.3) 2016 62 (20.9) Age, days 0–6 257 (86.8) 7–13 39 (13.2) Weight, kg 1.5 to <2.0 2 (0.7) 2.0 to <2.5 8 (2.7) 2.5 to <3.0 78 (26.4) ≥3.0 208 (70.3) Length, cm 40 to <45 4 (1.4) 45 to <50 139 (47.0) ≥50 153 (51.7) OFC, cm ≤30 7 (2.4) >30 to ≤31 17 (5.7) >31 to ≤32 48 (16.2) >32 to ≤33 91 (30.7) >33 133 (44.9) Abbreviation: OFC, occipital-frontal head circumference.
- TABLE 3.
Estimated Microcephaly Cases and Microcephaly Background Prevalence Using Established and Proposed Microcephaly Case Definitions in Neonates Born Between August 1, 2014, to March 31, 2016, in Rural Guatemala
Origin of Case Definition Microcephaly No. (%) Microcephaly Background Prevalence per 10,000 Live Births Brazil MOH 1 125 (42.2)a 4,223 Brazil MOH 2 48 (16.2)a 1,622 WHO 2 43 (14.5)b 1,453 WHO 1 36 (12.2)b 1,216 PAHO 2 20 (6.8)a 676 Fenton 2 20 (6.8)a 676 PAHO 1 15 (5.1)a 507 Fenton 1 13 (4.4)a 439 WHO 3 9 (3.0)b 304 Fenton 3 1 (0.3)a 34 Abbreviations: MOH, Ministry of Health; PAHO, Pan American Health Organization; WHO, World Health Organization.
↵a Based on infant's estimated GA using z-score of zero for length on Fenton growth curve adjusted for gender. Term if estimated GA ≥37 weeks; preterm if estimated GA <37 weeks.
↵b Assumes term (≥37 weeks) GA for all infants.
- TABLE 4.
Percent Agreement Between Established Microcephaly Case Definitions and Proposed Fenton Growth Curve Definitions
Fenton GC <−2 SD (n=13) Fenton GC <3rd Percentile (n=20) Fenton GC <−3 SD (n=1) No. (%) No. (%) No. (%) Brazil MOH 1 13 (100.0) 20 (100.0) 1 (100.0) Brazil MOH 2 11 (84.6) 18 (90.0) 1 (100.0) PAHO 1 5 (38.5) 11 (55.0) 1 (100.0) PAHO 2 6 (46.2) 12 (60.0) 1 (100.0) WHO 1 6 (46.2) 12 (60.0) 1 (100.0) WHO 2 7 (53.8) 13 (65.0) 1 (100.0) WHO 3 2 (15.4) 2 (10.0) 1 (100.0) Identified on all case definitions 5 (38.5) 11 (55.0) 1 (100.0) Abbreviations: GC, growth curve; MOH, Ministry of Health; PAHO, Pan American Health Organization; SD, standard deviation; WHO, World Health Organization.
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