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Post discharge growth assessment in preterm infants: implications of adopting the WHO standards

Carlos A Fustiñana1, Diana Rodríguez1, Gonzalo Mariani1

  • 1Servicio de Neonatología, Hospital Italiano de Buenos Aires.

Archivos Argentinos De Pediatria
|March 4, 2014
PubMed

Insights

The World Health Organization (WHO) growth standards for preterm infants showed higher rates of growth retardation compared to the Sociedad Argentina de Pediatría (SAP) standards. However, changing growth assessment standards did not significantly alter clinical follow-up practices in the first year.

Area of Science:

  • Pediatrics
  • Neonatology
  • Growth Monitoring

Background:

  • The World Health Organization (WHO) growth standards have been the benchmark for assessing infant growth since 1986.
  • Implementing WHO standards in Argentina could enhance the identification of suboptimal growth in preterm infants.

Purpose of the Study:

  • To compare growth retardation rates in preterm infants (birth weight <1500g) using WHO and Sociedad Argentina de Pediatría (SAP) standards.
  • To evaluate differences in weight, height, and head circumference assessments between the two standards.

Main Methods:

  • A cohort study included 204 preterm infants with very low birth weight (VLBW).
  • Anthropometric measurements (weight, height, head circumference) were taken at multiple postmenstrual weeks.
  • Statistical analysis involved Z-scores, Student's t-test, and chi-squared test to compare WHO and SAP standards.

Main Results:

  • The SAP standards indicated greater weight and height growth than WHO standards, particularly in males during the first year.
  • Growth retardation in height was noted with WHO standards for both sexes.
  • A significantly higher proportion of infants fell below -2 standard deviations for weight at 3 months using WHO standards (p < 0.01).

Conclusions:

  • Adopting WHO growth standards did not necessitate significant changes in clinical follow-up practices for preterm infants in their first year.
  • The study highlights subtle differences in growth assessment between WHO and SAP standards, particularly concerning weight in early infancy.
Abstract

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