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
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.
KeywordsPreterm Infant Growth Chart Fetal Weight Mental Developmental Index Psychomotor Developmental Index
World Health Organisation
Bayley Scale of Infant Development
Mental Developmental Index
Psychomotor Developmental Index
Extremely low birth weight
Neonatal Intensive Care Unit
Small for gestational age
Appropriate for gestational age
Centers for Disease Control and Prevention
Expected fetal weight
Royal College of Obstetricians and Gynaecologists.
Royal College of Paediatrics and Child health
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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