Valid serial length measurements in preterm infants permit characterization of growth patterns

The lack of a valid and safe method for measuring length in critically ill preterm neonates has led to a primary focus on weight gain.

Paucity of valid length measurements, precluding the accurate analysis of growth patterns.

Quality improvement project among infants < 29 weeks or small for gestational age < 35 weeks with embedded validation of (1) a caliper (infantometer) for length measurements and (2) length measurements during the first week to estimate birth length.

Implementation of valid methods to measure length.

We validated infantometer measurements and first week length measurements. The percentage of neonates with valid measurements during the first week rose from 10% to 78%, resulting in increased identification of classifiable growth patterns from < 10% to 89%.

By increasing the percentage of neonates with valid length measurements in the first week postnatal, we identified an increased number of neonates with classifiable growth abnormalities.