TY - JOUR
T1 - Monitoring the postnatal growth of preterm infants
T2 - A paradigm change
AU - Villar, Jose
AU - Giuliani, Francesca
AU - Barros, Fernando
AU - Roggero, Paola
AU - Zarco, Irma Alejandra Coronado
AU - Rego, Maria Albertina S.
AU - Ochieng, Roseline
AU - Gianni, Maria Lorella
AU - Rao, Suman
AU - Lambert, Ann
AU - Ryumina, Irina
AU - Britto, Carl
AU - Chawla, Deepak
AU - Ismail, Leila Cheikh
AU - Ali, Syed Rehan
AU - Hirst, Jane
AU - Teji, Jagjit Singh
AU - Abawi, Karim
AU - Asibey, Jacqueline
AU - Agyeman-Duah, Josephine
AU - McCormick, Kenny
AU - Bertino, Enrico
AU - Papageorghiou, Aris T.
AU - Figueras-Aloy, Josep
AU - Bhutta, Zulfiqar
AU - Kennedy, Stephen
N1 - Publisher Copyright:
© 2018 by the American Academy of Pediatrics. All rights reserved.
PY - 2018/2
Y1 - 2018/2
N2 - There is no consensus regarding how the growth of preterm infants should be monitored or what constitutes their ideal pattern of growth, especially after term-corrected age. The concept that the growth of preterm infants should match that of healthy fetuses is not substantiated by data and, in practice, is seldom attained, particularly for very preterm infants. Hence, by hospital discharge, many preterm infants are classified as postnatal growth-restricted. In a recent systematic review, 61 longitudinal reference charts were identified, most with considerable limitations in the quality of gestational age estimation, anthropometric measures, feeding regimens, and how morbidities were described. We suggest that the correct comparator for assessing the growth of preterm infants, especially those who are moderately or late preterm, is a cohort of preterm newborns (not fetuses or term infants) with an uncomplicated intrauterine life and low neonatal and infant morbidity. Such growth monitoring should be comprehensive, as recommended for term infants, and should include assessments of postnatal length, head circumference, weight/length ratio, and, if possible, fat and fat-free mass. Preterm postnatal growth standards meeting these criteria are now available and may be used to assess preterm infants until 64 weeks' postmenstrual age (6 months' corrected age), the time at which they overlap, without the need for any adjustment, with the World Health Organization Child Growth Standards for term newborns. Despite remaining nutritional gaps, 90% of preterm newborns (ie, moderate to late preterm infants) can be monitored by using the International Fetal and Newborn Growth Consortium for the 21st Century Preterm Postnatal Growth Standards from birth until life at home.
AB - There is no consensus regarding how the growth of preterm infants should be monitored or what constitutes their ideal pattern of growth, especially after term-corrected age. The concept that the growth of preterm infants should match that of healthy fetuses is not substantiated by data and, in practice, is seldom attained, particularly for very preterm infants. Hence, by hospital discharge, many preterm infants are classified as postnatal growth-restricted. In a recent systematic review, 61 longitudinal reference charts were identified, most with considerable limitations in the quality of gestational age estimation, anthropometric measures, feeding regimens, and how morbidities were described. We suggest that the correct comparator for assessing the growth of preterm infants, especially those who are moderately or late preterm, is a cohort of preterm newborns (not fetuses or term infants) with an uncomplicated intrauterine life and low neonatal and infant morbidity. Such growth monitoring should be comprehensive, as recommended for term infants, and should include assessments of postnatal length, head circumference, weight/length ratio, and, if possible, fat and fat-free mass. Preterm postnatal growth standards meeting these criteria are now available and may be used to assess preterm infants until 64 weeks' postmenstrual age (6 months' corrected age), the time at which they overlap, without the need for any adjustment, with the World Health Organization Child Growth Standards for term newborns. Despite remaining nutritional gaps, 90% of preterm newborns (ie, moderate to late preterm infants) can be monitored by using the International Fetal and Newborn Growth Consortium for the 21st Century Preterm Postnatal Growth Standards from birth until life at home.
UR - http://www.scopus.com/inward/record.url?scp=85041482122&partnerID=8YFLogxK
U2 - 10.1542/peds.2017-2467
DO - 10.1542/peds.2017-2467
M3 - Review article
C2 - 29301912
AN - SCOPUS:85041482122
SN - 0031-4005
VL - 141
JO - Pediatrics
JF - Pediatrics
IS - 2
M1 - e20172467
ER -