Dr. Abebe Muche Moges

Background: Anterior fontanelle is the largest, prominent and most important fontanelle, which is used for clinical evaluation. It is mainly characterized by its size and shape variation and is possibly influenced by gender, race and genetics. Understanding the variation of anterior fontanelle is used for recognition of different medical disorders and abnormal skeletal morphogenesis. Objective: To determine the mean size of anterior fontanelle among term neonates on the first day of life born at University of Gondar Hospital, Gondar Town, Northwest Ethiopia, 2018. Methods: Descriptive cross sectional study design was undertaken in 384 term and apparently healthy neonates, using standard methods. Descriptive analysis, student t-test, one way ANOVA and Pearson correlation coefficient were implemented. Results: In this study, the mean size of anterior fontanelle in term neonates was 3.00 ± 0.62 cm (range 1.70-5.50 cm). The mean size of anterior fontanelle was 3.10 ± 0.66 cm for males, and 2.88 ± 0.57 cm for females. There was statistically significant difference in anterior fontanelle size in neonates of different genders (p<0.001), mode of delivery (p<0.001) and duration of labour (p = 0.006). However, the size of anterior fontanelle was not significantly affected by the birth order, onset of labour and socio-demographic variables of the mother except occupation of the mother (p = 0.01). There was a significant positive correlation between the mean size of anterior fontanelle with birth weight (r = 0.11; p = 0.04) and head circumference (r = 0.17; p = 0.001). Conclusions: At term, male neonates had significantly larger anterior fontanelle than female neonates and anterior fontanelle size has a direct relationship with birth weight and head circumference.

Background: Fontanel can be defined as a space where two or more sutures meet. There are six fontanels in the newborn skull, namely anterior, posterior, two mastoid, and two sphenoid fontanels. The anterior fontanel is the most important for clinical evaluation. In Ethiopia, there is a paucity of information regarding the size of anterior fontanel dimensions . Thus, this study aimed to determine and compare the average values of the length and width of the anterior fontanel and to identify the factors that affect the dimensions. Method: An institution-based cross-sectional study was conducted on three hundred eighty-four healthy and term newborns. A systematic sampling technique was used to select study subjects. The data were collected using interviewer-administered questionnaire by interviewing the mothers of the neonates. The examination included assessment of the length and width of the anterior fontanel, birth weight, and head circumference. Socio-demographic, pregnancy, and labor variables were also recorded. Descriptive analysis, simple linear and multiple linear regression analysis were applied to analyze the data. Result: The mean length and width of the anterior fontanel was 3.07 ± 0.69 cm and 2.92 ± 0.61 cm, respectively. Cesarean mode of delivery (ABC (Adjusted B-Coefficient) = 0.09, 95% CI: 0.002, 0.18)), being daily laborer (ABC = -0.23, 95% CI: - 0.41, -0.05), width of anterior fontanel (ABC = 0.91, 95% CI: 0.84, 0.98), and head circumference (ABC = 0.03, 95% CI: 0.001, 0.050) were independently associated with length of anterior fontanel. Age of the newborn (ABC= 0.01, 95% CI: 0.008, 0.02) was associated with width of the anterior fontanel. Conclusion: At birth, the mean length of the anterior fontanel was larger than the mean width of the anterior fontanel. This study provides an insight on the mean length and width anterior fontanel for term neonates in the study area. which can serve as a baseline for future larger sample size studies to set reference values for the area.. Keywords: Length of anterior fontanel, width of anterior fontanel, comparison, newborns.