Medical Student Research Fellowship for Summer 2007

Mentor: Gregory ("Greg") L. Jackson, M.D., M.B.A.
Department: Pediatrics
Room number: Parkland Memorial Hospital Newborn Nursery
Mail Code: 9063
Phone number: (214) 590-8034
E-mail: greg.jackson@utsouthwestern.edu
Project title: Measurement of the anterior fontanel in term and late preterm Hispanic neonates: description of normal measurements and proposal of an alternate measurement method

Human subjects IRB approved project number (where applicable): IRB is pending

Animal subjects IRB approved project number (where applicable): N/A

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) - Patient-based

Brief Description of Project:
We propose to non-invasively measure (with plastic calipers) the anterior fontanel size in 500 Hispanic neonates of gestational ages between 35-42 weeks, provide a graph for the current measurement (average of the length plus width - see drawing), and measure alternative dimensions of the anterior fontanel.
Babies from the Normal Newborn Nursery at Parkland Memorial Hospital (NBN) - who are ?35 weeks gestation and ?2100 grams - will be recruited for the study. Each parent will be informed of the study and asked to sign an abbreviated consent form before the anterior fontanel is measured. The measurements will be taken when the baby is >24 and <48 hours of age.
The fontanel measurements will be made using a single pair of digital plastic calipers. The calipers are accurate to about 0.1 mm. Head circumference will be measured with a paper tape. Once the patient's parent has consented, the baby's fontanel will be measured, as well as the head circumference, and dimensions will be recorded.
Our goal is to develop normative data for anterior fontanels in Hispanic neonates, including graphs of the traditional versus alternative methods of measurement.

importance / implications of the research: Clinicians still use the size of the anterior fontanel as a gross estimate to assess the ossification of bones, and consider disorders such as hypothyroidism, osteogenesis imperfecta, and achondroplasia when they encounter a large anterior fontanel. Since the normal values of anterior fontanel size were studied in about 120 Caucasian babies who ranged in age from birth to one year of age, these normal values may not apply to Hispanic neonates shortly after birth. Therefore, we will collect normative data on exclusively Hispanic newborns within the first 1-2 days of life. We intend to publish this data, after developing numerical scores of 'normal size.'

Role of the student: The student will be involved in the consent process for obtaining measurements, measurements of the anterior fontanel in 500 Hispanic neonates, data collection and analysis, and preparation of both a poster and manuscript for this topic.