Growth Assessment in Preterm Children from Birth to Preschool Age

Area of Science:

• Neonatalogy
• Pediatric Endocrinology
• Growth Monitoring

Background:

• Preterm infant growth is a key health indicator requiring appropriate monitoring to optimize development and prevent future metabolic issues.
• New international standards for preterm infant size at birth and postnatal growth are available for clinical implementation.

Purpose of the Study:

• To evaluate the effectiveness of new international growth standards in monitoring the in-hospital and long-term growth of preterm infants.
• To compare the INTERGROWTH-21st standards with traditional neonatal charts for diagnosing extrauterine growth restriction.

Main Methods:

• A prospective, single-center observational study of 80 preterm infants (mean gestational age 33.3 ± 2.2 weeks).
• Assessment of size at birth and discharge using INTERGROWTH-21st standards.
• Preschool age growth assessed with World Health Organization (WHO) child growth standards.

Main Results:

• The INTERGROWTH-21st Preterm Postnatal longitudinal standards significantly reduced the diagnosis of short-term extrauterine growth restriction compared to traditional charts (p < 0.0001).
• A combined package of birth, preterm postnatal, and WHO growth standards demonstrated consistency and effectiveness in monitoring growth.
• Infants identified as small for gestational age at birth more frequently required auxological referral.

Conclusions:

• The implementation of INTERGROWTH-21st standards improves the monitoring of preterm infant growth, reducing misdiagnosis of growth restriction.
• A comprehensive approach using multiple growth standards is effective for tracking growth in preterm infants without major morbidities.
• Early identification of small for gestational age infants is important for timely auxological assessment.