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Predicting weight using postmenstrual age--neonates to adults.

Anita L Sumpter¹, Nick H G Holford

¹Department of Anaesthesiology, University of Auckland School of Medicine, Auckland, New Zealand.

Paediatric Anaesthesia

|February 16, 2011

Summary

A new mathematical model describes body weight changes from infancy to adulthood using postmenstrual age (PMA). This model accounts for sex differences and variability, offering a single function for weight prediction across the lifespan.

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Area of Science:

Human growth and development
Pharmacokinetics and pharmacodynamics
Biostatistics

Background:

Postmenstrual age (PMA) is a predictor of physiological functions like glomerular filtration rate and drug clearance.
Current growth charts rely on postnatal age and do not offer a predictive mathematical function for weight.
A unified mathematical model for weight across the lifespan is needed.

Purpose of the Study:

To model the pattern and variability of body weight relative to postmenstrual age (PMA).
To develop a single mathematical function for weight prediction from prematurity through adulthood.
To incorporate sex-specific differences and between-subject variability into the weight model.

Main Methods:

Utilized a pooled database of 7164 body weight observations from 5031 individuals (premature neonates to adults).
Applied nonlinear mixed-effects modeling to analyze body weight and PMA data.
Modeled fixed effects (PMA, sex) and random between-subject variability.

Main Results:

A mathematical model combining three sigmoid hyperbolic and one exponential function accurately described the body weight data.
Females were observed to have approximately 12% lower body weight.
Between-subject variability in weight decreased exponentially over time, with a portion remaining a constant fraction of the weight asymptote.

Conclusions:

A straightforward equation can describe body weight changes in relation to PMA and sex.
The developed model facilitates simulations of typical weight-age distributions.
This model can aid in assessing appropriate weight for age in pediatric medical contexts.