Nomograms and Reference Ranges for Intra-Cranial Ventricular Dimensions in Indian Neonates

To establish normal reference values for commonly used ventricular indices – Anterior Horn Width (AHW), Ventricular Index (VI) and Thalamo-Occipital Distance (TOD)—against common variables including gestational age, birth weight and head circumference in Indian newborns.

This was a cross-sectional study. Cranial ultrasound was performed between post-natal days 3 to 7. Anterior fontanelle was taken as the acoustic window. Data were analyzed to determine correlation, coefficient of determination (R2), regression equations and plotted against gestational age (GA).

Total 2200 newborns were included in the study. The study observed that there is an increase in VI, AHW and TOD with an increase in gestational age (p-value < 0.001) and birth weight (p-value < 0.001). No significant correlation of gender and singleton or multiple gestation—with the intraventricular dimensions was observed (p-value > 0.05). All the three ventricular parameters were found to have a significantly lower mean value in the normal vaginal delivery group as compared to the LSCS group. There was a good correlation between ventricular indices of the left and right side. Nomograms of AHW, TOD, and VI were prepared with respect to gestational age.

Intracranial ventricular size dimensions vary significantly with increasing gestational age and birth weight. The new nomograms for various ventricular indices of Indian neonates can assist in objectively assessing ventricular sizes.