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Postnatal Growth Failure and Z-Score

  • Haydi Al-Wassia
  • Prakesh S. Shah
Chapter

Abstract

Advances in neonatal intensive care have resulted in remarkable improvements in the survival of the sickest and extremely premature newborn infants. However, this has resulted in an increase in morbidities and significant impact on long-term neurodevelopmental outcomes. Optimizing, monitoring and achieving nutritional adequacy and growth of this group of infants remain significant challenges during their course in neonatal intensive care units. Postnatal growth failure is extremely common in these infants. Several studies have reported the negative effect of suboptimal growth on long-term neurodevelopmental outcomes. Despite this, there is a lack of uniformity among neonatologists with regard to the best method of assessing growth of the preterm infant and the best definition of postnatal growth failure. Various methods used to assess growth of preterm infants during their NICU stay and during infantile and childhood periods are discussed in this chapter. Methods using standardized scores such as z-score have the advantage of individualizing a growth chart and monitor growth of an individual child with reference to his/her own growth potential and at the same time with reference to population standards. Z-scores also have the advantage of accommodating extreme values of growth. Emerging evidence indicates that z-score is moderately correlated with neurodevelopmental outcome in childhood whereas other measures have failed to achieve significance. In this chapter, we review available evidence regarding utility of z-scores in monitoring postnatal growth.

Keywords

Preterm Infant Neonatal Intensive Care Unit Postnatal Growth Growth Chart Neurodevelopmental Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

AAP

American Academy of Paediatrics

AGA

Appropriate for gestational age

BW

Birth weight

CDC

Center for Disease Control

CPS

Canadian Paediatric Society

ELBW

Extremely low birth weight

FT

Full term

GA

Gestational age

IHDP

Infant Health and Development Program

NICHD

National Institute of Child Health and Human Development

NICU

Neonatal intensive care unit

OR

Odds ratio

PGF

Postnatal growth failure

PT

Preterm

SBP

Systolic blood pressure

SD

Standard deviation

SGA

Small for gestational age

VLBW

Very low birth weight

WHO

World Health Organization

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PediatricsMount Sinai Hospital, University of TorontoTorontoCanada
  2. 2.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada

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