Postnatal growth of preterm infants: which reference charts?

Area of Science:

• Neonatalogy
• Pediatric Growth Monitoring
• Public Health

Background:

• Improved neonatal care has increased preterm infant survival, making them a majority in NICUs.
• Accurate postnatal growth evaluation for preterm infants is a growing concern, yet optimal patterns and monitoring strategies remain debated.
• Current growth charts (fetal, neonatal anthropometric, term postnatal) are unsuitable for preterm infants.

Purpose of the Study:

• To address the lack of appropriate growth charts for preterm infants.
• To highlight the limitations of existing growth monitoring tools for this population.
• To propose interim solutions for preterm infant growth assessment in clinical practice.

Main Methods:

• Review of current practices and limitations in preterm infant growth monitoring.
• Identification of the need for a dedicated international prescriptive standard for preterm infant growth.
• Proposal of a tiered approach using existing charts as a temporary measure.

Main Results:

• No single existing chart accurately assesses preterm infant postnatal growth.
• An international project is underway to develop a new standard for preterm infant growth evaluation.
• Current Italian clinical practice suggests a stepwise chart usage: INeS charts up to term, WHO/CDC charts from term to two years, and SIEDP charts from two to 20 years.

Conclusions:

• Existing growth charts are insufficient for preterm infants.
• A new international standard for preterm infant growth is essential and forthcoming.
• A pragmatic approach using specific chart sequences is recommended in Italy pending the new standard.