Comparing growth charts demonstrated significant deviations between the interpretation of postnatal growth patterns...

Area of Science:

• Neonatalogy
• Pediatric Growth Monitoring
• Biostatistics

Background:

• Accurate assessment of postnatal growth in very preterm infants is essential for monitoring development.
• Existing reference data for infant growth may yield varied interpretations.
• Standardization of growth assessment is needed for clinical practice.

Purpose of the Study:

• To compare postnatal growth patterns in very preterm infants using different reference data.
• To evaluate the impact of various growth charts on Z-score calculations for weight, length, and head circumference.
• To highlight discrepancies in growth interpretation based on chosen reference populations.

Main Methods:

• A cohort of 551 very preterm infants from Tyrol, Austria, was studied.
• Infant anthropometric data (weight, length, head circumference) were collected at multiple time points from birth to 24 months corrected age.
• Growth Z-scores were calculated using four distinct reference populations: Pan et al. LMS, Fenton, Euro-Growth, and WHO Anthro.

Main Results:

• Significant differences in mean weight Z-scores were observed across the four reference populations, with WHO data yielding the highest values.
• Mean head circumference Z-scores also showed significant variations at all measured time points.
• Microcephaly rates at 24 months were notably higher (10-fold increase) when using Pan data compared to WHO data.

Conclusions:

• The interpretation of very preterm infant postnatal growth is significantly influenced by the choice of reference data.
• Striking differences were noted in head circumference assessments, impacting diagnoses like microcephaly.
• Clinical conclusions drawn from growth data necessitate careful consideration and interpretation of the selected reference standards.