Growth monitoring of low birthweight infants: what references to use?

Area of Science:

• Pediatrics
• Neonatology
• Growth Monitoring

Background:

• Growth charts are critical for monitoring infants born small or preterm.
• Existing centile charts have limitations, often underestimating growth restriction in preterm infants.
• The use of cross-sectional data for longitudinal growth monitoring presents challenges.

Purpose of the Study:

• To review the limitations of current growth charts for preterm and small-for-gestational age infants.
• To discuss the appropriate use of customised centile charts for antenatal and birthweight assessment.
• To emphasize the importance of monitoring growth trajectories in infancy for proportional growth.

Main Methods:

• Literature review of existing growth monitoring practices.
• Discussion of current clinical practice in Australia and New Zealand.
• Analysis of the evidence base for customised centile charts.

Main Results:

• Most birthweight centile charts underestimate growth restriction in preterm infants.
• There is a lack of robust evidence supporting the routine use of customised centile charts antenatally.
• Faltering post-natal growth in preterm infants is common but can be managed with nutritional support.

Conclusions:

• Awareness of chart limitations is crucial for accurate growth assessment.
• Further research is needed to establish the role of customised centile charts in clinical practice.
• Close attention to nutrition and monitoring growth trajectories are vital for optimal infant development.