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Generating longitudinal growth charts from preterm infants fed to current recommendations
Aneurin Young1,2, Edward T Andrews3, James John Ashton4,5
1Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK a.young@soton.ac.uk.
Insights
New growth charts for very preterm infants fed according to current recommendations provide a benchmark for achievable early growth. These charts, based on serial measurements of weight, length, and head circumference, reflect real-world growth patterns.
Area of Science:
- Neonatalogy
- Pediatric Growth Monitoring
- Nutritional Science
Background:
- Preterm infants require specialized growth monitoring due to altered growth trajectories.
- Current growth charts may not accurately reflect the growth of preterm infants receiving modern nutritional support.
- Establishing benchmarks for early growth in preterm infants is crucial for clinical management.
Purpose of the Study:
- To develop growth centile charts for very preterm infants using serial measurements.
- To reflect real-world growth patterns in a cohort with nutrient intake close to recommendations.
- To provide a benchmark for achievable early growth in this population.
Main Methods:
- Recruited infants born before 30 weeks gestational age (GA).
- Collected serial data on weight, length, and head circumference.
- Utilized the LMS method to construct centile charts from 24 to 36 weeks corrected GA.
Main Results:
- Median nutrient intake was within 3% of recommendations.
- Generated centile charts for weight, length, and head circumference.
- Developed a web application for plotting infant growth (bit.ly/sotongrowth).
Conclusions:
- The developed charts accurately reflect growth in a real-world cohort of preterm infants.
- These charts serve as a valuable tool for clinicians to assess early growth.
- Demonstrates the feasibility of creating growth charts based on current nutritional recommendations.
Objective:
To use repeated measurements of weight, length and head circumference to generate growth centile charts reflecting real-world growth of a population of very preterm infants with a well-described nutritional intake close to current recommendations.
Design:
Infants born before 30 weeks gestational age (GA) were recruited. Infants received nutrition according to an integrated care pathway, with nutrient intake recorded daily, weight recorded twice-weekly and length and head circumference weekly. The LMS method was used to construct growth centile charts between 24 and 36 weeks corrected GA for each parameter.
Setting:
A single tertiary neonatal unit in England.
Patients:
212 infants (124 male) (median GA at birth: 27.3 weeks, median birth weight: 900 g).
Results:
Median daily energy, protein, carbohydrate and fat intake were within 3% of published recommendations. The total number of measurements recorded was 5944 (3431 for weight, 1227 for length and 1286 for head circumference). Centile charts were formed for each parameter. Data for male and female infants demonstrated similar patterns of growth and were pooled for LMS analysis. A web application was created and published (bit.ly/sotongrowth) to allow infants to be plotted on these charts with changes in SD score of measurements reported and graphically illustrated.
Conclusions:
These charts reflect growth in a real-world cohort of preterm infants whose nutrient intakes are close to current recommendations. This work demonstrates the feasibility of forming growth charts from serial measurements of growing preterm infants fed according to current recommendations which will aid clinicians in setting a benchmark for achievable early growth.
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