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Reference Values for Abdominal Circumference in Premature Infants

Héléna Setruk1, Erika Nogué2, Aurélie Desenfants3

  • 1Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France.

Frontiers in Pediatrics
|March 3, 2020
PubMed

Insights

This study developed reference charts for abdominal circumference (AC) and the AC to head circumference (AC/HC) ratio in premature infants. The AC/HC ratio is a more reliable indicator than AC alone for diagnosing abdominal distention and feeding intolerance.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Medical Statistics

Background:

  • Abdominal distention is a common, yet subjective, indicator of feeding intolerance in premature newborns.
  • Objective criteria are needed to standardize the assessment of abdominal distention in this vulnerable population.

Purpose of the Study:

  • To create reference charts and smoothed percentiles for abdominal circumference (AC) and the AC to head circumference (AC/HC) ratio.
  • To establish objective measures for assessing feeding tolerance and abdominal distention in premature infants (24-34 weeks gestational age).

Main Methods:

  • Collected weekly abdominal circumference (AC) and head circumference (HC) measurements in 373 premature infants.
  • Utilized the LMS method to model AC and AC/HC charts, excluding infants with congenital abnormalities or signs of distention/intracranial issues.
  • Employed mixed-effects linear models to analyze changes in AC and AC/HC over time.

Main Results:

  • Generated reference curves for AC and AC/HC based on gestational and postnatal age.
  • Found that gestational age, postnatal age, singleton status, and respiratory support significantly influenced AC and AC/HC.
  • Observed a significantly higher AC/HC ratio in infants with abdominal distention (0.95) and necrotizing enterocolitis (0.98) compared to those without (0.91).

Conclusions:

  • The developed AC and AC/HC reference charts can aid in evaluating feeding tolerance in premature infants.
  • The AC/HC ratio is a more sensitive and relevant metric than AC alone for objectively diagnosing abdominal distention in neonates.

Keywords:
abdominal circumferenceabdominal distentionfeeding intolerancenecrotizing enterocolitispremature neonate

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