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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Conceptual issues related to the construction of prescriptive standards for the evaluation of postnatal growth of
J Villar1, H E Knight, M de Onis
1Nuffield Department of Obstetrics and Gynaecology, and Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK. jose.villar@obs-gyn.ox.ac.uk
Insights
New growth standards are needed for preterm infants to improve neonatal care. These standards should be based on healthy infants to ensure accurate monitoring and evidence-based clinical practices.
Area of Science:
- Neonatology
- Pediatric Growth Monitoring
Background:
- Current growth charts for preterm infants may not be appropriate for modern neonatal care.
- There is a need for updated, robust standards to accurately interpret preterm infant growth.
Purpose of the Study:
- To propose the development of new international prescriptive growth standards for preterm infants.
- To establish standards based on a carefully selected population of healthy preterm infants.
Main Methods:
- Define criteria for selecting preterm infants for new standards: no impaired fetal growth, born to low-risk mothers, precise gestational age dating.
- Exclude infants with congenital malformations or conditions affecting postnatal growth.
- Ensure infants receive standardized, evidence-based care and follow current feeding recommendations.
Main Results:
- The proposed methodology aims to create a population dataset conceptually similar to WHO growth standards.
- This approach will yield new, evidence-based international standards for preterm infant growth.
Conclusions:
- Developing new prescriptive growth standards is crucial for advancing the evidence-based care of preterm infants.
- These standards will enhance the accuracy and appropriateness of growth monitoring in neonatal settings.
Abstract:
Monitoring and interpreting the growth of preterm infants is a major clinical task for neonatologists. The effectiveness of this process depends upon the robustness of the standard selected. Concerns have been raised regarding the nature of the charts currently being used, as well as their appropriateness for present-day neonatal care. To overcome these problems, there is a need for new prescriptive standards based on a population of preterm infants without evidence of impaired fetal growth and born to low-risk women followed up since early pregnancy for precise gestational age dating. Preterm infants contributing to the new standards should be free of congenital malformations and major clinical conditions associated with impaired postnatal growth. These infants should receive standardised, evidence-based clinical care and should follow current feeding recommendations based on exclusive/predominant breastfeeding. This strategy should provide a population that is conceptually as close as possible to the prescriptive approach used for the construction of the WHO infant and child growth standards. New international standards constructed in this way should contribute to the evidence-based care of these preterm infants.
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