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Monitoring the Growth of Preterm Infants During and After Their Stay in the Neonatal Intensive Care Units: A Focus on WHO Growth Curves After Discharge

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Handbook of Growth and Growth Monitoring in Health and Disease

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Abstract

The growth curves routinely used for monitoring preterm infants are four decades old and may not be suitable for the current population. Intrauterine growth rate theoretically appears to be the ideal growth that needs to be replicated in the immediate postnatal period, but this may not be feasible given the limitations set by the morbidities of prematurity. Postnatal growth curves describe the actual growth of the preterm infants during their stay in neonatal units and are descriptive rather than prescriptive. The Fenton chart which has updated the Babson and Benda’s chart with data from very large sample size of preterm infants born in the last two decades appears to be suitable for monitoring growth of preterm infants during their stay in the neonatal units. After discharge from the neonatal intensive care units and post-conceptional age of 40 weeks is reached, the recently released WHO growth curves appear suitable for monitoring their ongoing growth. While aiming to achieve intrauterine growth velocities in the immediate postnatal life, one should not overlook the potential short-term (e.g. necrotising enterocolitis and broncho-pulmonary dysplasia) and long-term (excessive catch-up growth with cardiovascular morbidity and diabetes) adverse effects of aggressive nutrition. Further research is needed to identify the best growth curves for monitoring these high-risk infants.

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Abbreviations

WHO:

World Health Organisation

BSID:

Bayley Scale of Infant Development

MDI:

Mental Developmental Index

PDI:

Psychomotor Developmental Index

ELBW:

Extremely low birth weight

NICU:

Neonatal Intensive Care Unit

IQ:

Intelligence quotient

SGA:

Small for gestational age

AGA:

Appropriate for gestational age

CP:

Cerebral palsy

SD:

Standard deviation

CDC:

Centers for Disease Control and Prevention

EFW:

Expected fetal weight

RCOG:

Royal College of Obstetricians and Gynaecologists.

RCPCH:

Royal College of Paediatrics and Child health

UK:

United Kingdom

BPD:

Biparietal diameter

HC:

Head circumference

AC:

Abdominal circumference

FL:

Femoral length

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Acknowledgements

We are thankful to Drs Tanis Fenton, Mercedes de Onis, and Jason Gardosi for giving us the permission to reproduce relevant material from their published work.

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Authors and Affiliations

  1. Princess Margaret Hospital for Children, Centre for Neonatal Research and Education, University of Western Australia, Subiaco, WA, 6008, Australia

    Shripada C. Rao

  2. King Edward Memorial Hospital for Women, Centre for Neonatal Research and Education, University of Western Australia, Subiaco, WA, 6008, Australia

    Shripada C. Rao & Sanjay Patole

Authors
  1. Shripada C. Rao
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  2. Sanjay Patole
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Corresponding author

Correspondence to Shripada C. Rao .

Editor information

Editors and Affiliations

  1. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

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Rao, S.C., Patole, S. (2012). Monitoring the Growth of Preterm Infants During and After Their Stay in the Neonatal Intensive Care Units: A Focus on WHO Growth Curves After Discharge. In: Preedy, V. (eds) Handbook of Growth and Growth Monitoring in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1795-9_27

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  • DOI: https://doi.org/10.1007/978-1-4419-1795-9_27

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