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Updated: May 31, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Evaluation of postnatal growth of preterm infants
Enrico Bertino1, Paola Di Nicola, Francesca Giuliani
1Neonatal Intensive Care Unit, Turin, Italy. enrico.bertino@unito.it
Insights
Evaluating preterm infant growth is crucial, but current charts are inadequate. New international standards are needed to accurately monitor the postnatal development of these vulnerable neonates.
Area of Science:
- Neonatology
- Pediatric Growth Monitoring
- Infant Development
Background:
- Survival rates for preterm infants, especially those born before 30 weeks gestational age, have improved significantly over the past two decades.
- These neonates form the majority in neonatal intensive care units, making accurate postnatal growth evaluation a primary concern.
- Current growth charts (fetal, neonatal anthropometric, term infant postnatal) are unsuitable for preterm infants.
Purpose of the Study:
- To address the lack of appropriate growth monitoring tools for preterm infants.
- To highlight the controversy surrounding optimal postnatal growth patterns and monitoring strategies for preterm neonates.
- To introduce an upcoming international project aimed at developing a prescriptive standard for preterm infant growth evaluation.
Main Methods:
- Review of current clinical practices for preterm infant growth assessment.
- Identification of limitations in existing growth charts (fetal, neonatal, term infant).
- Mention of an ongoing international multicentric project to create new growth standards.
Main Results:
- Existing growth charts are not suitable for evaluating preterm infant growth.
- An international project is underway to develop a prescriptive standard for preterm infant growth, aligning with WHO methodologies.
- Current Italian clinical practice utilizes a combination of INeS, WHO 2006/CDC 2002, and SIEDP 2006 charts as a compromise.
Conclusions:
- There is a critical need for validated, international longitudinal growth standards for preterm infants.
- The development of new prescriptive growth charts is essential for accurate monitoring.
- Current clinical practice in Italy employs a multi-chart approach as a temporary solution pending new standards.
Abstract:
The past two decades have seen a progressive improvement in the survival rates of preterm infants, especially in neonates <30 weeks of gestational age. These neonates constitute the large majority of the population in neonatal intensive care units. The correct evaluation of postnatal growth of these babies is nowadays of primary concern, although the definition of their optimal postnatal growth pattern is still controversial. Concerns have also been raised about the strategies to monitor their growth, specifically in relation to the charts used. At present the available charts in clinical practice are fetal growth charts, neonatal anthropometric charts and postnatal growth charts for term infants. None of these, for different reasons, is suitable to correctly evaluate preterm infant growth. An international multicentric project has recently started a study aiming at building a prescriptive standard for the evaluation of postnatal growth of preterm infants and it will be available in the next years providing 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. At present, while an international longitudinal standard for evaluating preterm infant postnatal growth is lacking, in Italy the best compromise in clinical practice is likely to be as follows: new Italian INeS (Italian Neonatal Study) charts up to term; International longitudinal charts WHO 2006 or CDC 2002 from term to two years; finally the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP) 2006 growth charts could be suitable for monitoring the growth of these infants from two years up to 20 years of age.
