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Gestational age-specific growth parameters for infants born at US military hospitals
LoRanee Braun1, Deirdre Flynn, Chia-Wen Ko
1Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC, USA.
Insights
Current military hospital growth charts are outdated. New research indicates infants born in military hospitals are larger, necessitating updated growth curves for accurate infant assessment and care.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Current gestational age-specific growth curves used in military hospitals are based on data from 1948-1961.
- Changes in population, environment, and medical practices may render these historical curves unrepresentative of current infant populations.
Purpose of the Study:
- To evaluate the representativeness of existing growth curves for infants born in military hospitals.
- To develop new, accurate growth curves tailored for military hospital use.
Main Methods:
- Analysis of medical records from tertiary and primary care military hospitals.
- Creation of new growth curves for birth weight, length, and head circumference (23-42 weeks gestational age).
- Comparison with previous norms and national statistics; assessment of racial/ethnic variations and infant blood-glucose levels.
Main Results:
- Infants born in military hospitals exhibit significantly increased growth parameters compared to historical data.
- Racial and ethnic subgroups within the military also show increased growth relative to national averages.
- Hypoglycemia was rare (<1%) in infants classified as average for gestational age (AGA) by new curves, even if large for gestational age (LGA) by old standards.
Conclusions:
- Existing published growth curves may not accurately reflect current infant growth in military settings.
- Term infants born in military hospitals, including specific racial and ethnic subgroups, are larger than their civilian counterparts.
- Prospective validation of new curves is recommended for long-term applicability in military and civilian nurseries.
Background:
Military hospitals currently use gestational age-specific growth curves based on data collected in Denver, Colo, from 1948 to 1961. A number of population and environmental factors and medical practice changes may make these curves nonrepresentative.
Objective:
Determine if presently used growth curves represent norms for infants born in military hospitals and create new curves for use in military hospitals.
Methods:
Data were collected from medical records of tertiary- and primary-care military hospitals. We created growth curves created for birth weight, length, and head circumference and compared these curves at gestational ages 23-42 weeks to previously published norms and to 1998 national vital statistics. Racial and ethnic differences between groups were compared. A retrospective analysis of blood-glucose measurements for healthy term infants was performed to identify potential safety issues.
Results:
Significant increases in growth parameters were noted for infants born in military hospitals. Specific racial and ethnic groups within the military also had an increase when compared with these groups in the United States as a whole. Less than 1% of infants classified as large for gestational age (LGA) according by old standards but average for gestational age (AGA) according to new curves experienced hypoglycemia.
Conclusion:
Published growth curves may not represent infants born in military hospitals. Term infants born in military hospitals as a group and in racial and ethnic subgroups are larger than term infants born in US civilian hospitals. Prospective use of curves will help to validate their long-term applicability in military and civilian nurseries.
