Postnatal percentile growth charts for Indian appropriate for gestational age (AGA) very low birth weight babies

Area of Science:

• Neonatalogy
• Pediatric Growth and Development
• Public Health Nutrition

Background:

• Existing intrauterine growth charts do not adequately represent Indian very low birth weight (VLBW) infants.
• Postnatal growth patterns of VLBW infants vary significantly based on gestational age and ethnicity.
• Accurate growth monitoring is crucial for identifying growth faltering and optimizing outcomes in preterm infants.

Purpose of the Study:

• To establish postnatal percentile growth charts for Indian VLBW infants appropriate for gestational age (AGA).
• To track growth up to 37 weeks post conceptional age (PCA).
• To provide a reference standard for assessing the growth of Indian VLBW AGA babies.

Main Methods:

• A prospective, mixed longitudinal study involving 105 VLBW AGA infants (<1500g, <34 weeks gestation).
• Daily weight measurements until discharge, followed by weekly measurements until 37 weeks PCA.
• Percentile weight curves (3rd to 97th) were generated using Tanner's 1951 method, categorized by gestational age groups (≤28, 29-30, 31-32, 33 weeks).

Main Results:

• At birth, all infants were below the 50th percentile on Lubchenco's intrauterine growth chart, with this trend more pronounced in higher gestations.
• By 37 weeks PCA, all infants were below the 10th percentile, with the lowest percentiles observed in the ≤28 weeks gestation group.
• Indian VLBW AGA infants demonstrated slower postnatal growth compared to Western reference data.

Conclusions:

• Indian VLBW AGA infants are born smaller and exhibit slower postnatal growth rates than their Western counterparts.
• Infants born at the lowest gestations experienced the slowest postnatal growth.
• Development of specific postnatal growth charts for Indian VLBW AGA infants is essential for accurate monitoring and clinical management.