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Predictive ability of postnatal growth failure for adverse feeding-related outcomes in preterm infants: an

Sreekanth Viswanathan1, Erika Osborn2,3, Sudarshan Jadcherla2,3

  • 1Department of Pediatrics, Division of Neonatology, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, FL, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|February 12, 2021
PubMed

Insights

Defining postnatal growth failure (PGF) in preterm infants using different growth charts shows limited predictive ability for adverse feeding outcomes. This study compared Fenton and INTERGROWTH-21st charts to find the best PGF definition for predicting feeding issues.

Area of Science:

  • Neonatalogy
  • Pediatric Growth Monitoring
  • Nutritional Pediatrics

Background:

  • Postnatal growth failure (PGF) affects preterm infant outcomes.
  • PGF rates differ based on definition and growth chart used.
  • Fenton-2013 charts track intrauterine growth, while INTERGROWTH-21st monitors extrauterine preterm growth.

Purpose of the Study:

  • To identify the definition of PGF at first oral feeding that best predicts adverse feeding-related outcomes in preterm infants.
  • To compare the predictive performance of PGF definitions using Fenton-2013 and INTERGROWTH-21st growth charts.

Main Methods:

  • Reviewed prospectively collected data of preterm infants (24-32 weeks gestation).
  • Compared anthropometric data (weight, length, head circumference) at first oral feed using Fenton and INTERGROWTH-21st charts.
  • Defined PGF using percentile (<10th) or Z-score change (≥-1.5 or ≥-2.0) and assessed prediction of adverse feeding outcomes (e.g., time to full feeds, length of stay).

Main Results:

  • Both growth charts showed similar incidences of appropriate, small, and large for gestational age at birth.
  • Fenton chart showed a significantly higher Z-score change of -1.5 for weight at first oral feed compared to INTERGROWTH-21st.
  • Combined PGF definitions using both charts had moderate sensitivity and negative predictive value but low specificity and positive predictive value for adverse feeding outcomes.

Conclusions:

  • Current definitions of PGF at first oral feeding offer only small to moderate predictive ability for adverse feeding-related outcomes in preterm infants.
  • Further research is needed to develop more accurate predictors of feeding outcomes in this population.
Abstract

Keywords:
Postnatal growthgrowth chartsoral feedingpostnatal nutritionpreterm infants

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