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Published on: August 25, 2014
Fenton vs. Intergrowth-21st: Postnatal Growth Assessment and Prediction of Neurodevelopment in Preterm Infants
Miheret Yitayew1,2, Nayef Chahin1, Salem Rustom3
1Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA.
Insights
Accurate growth monitoring is crucial for preterm infants. Weight-based growth failure, identified by either Fenton or Intergrowth-21st (IG-21st) tools, is linked to impaired neurodevelopmental outcomes.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Developmental Pediatrics
Background:
- Improved survival rates for preterm infants have highlighted growth failure and neurodevelopmental issues as significant morbidities.
- Optimal nutrition and accurate growth monitoring are essential for preterm infants' well-being and long-term health.
- Current consensus is lacking on the best growth assessment tool for preterm infants to guide nutrition and predict neurodevelopment.
Purpose of the Study:
- To compare the performance of Fenton and Intergrowth-21st (IG-21st) growth assessment tools.
- To evaluate their effectiveness in classifying birth size, identifying postnatal growth failure, and predicting neurodevelopmental outcomes in preterm infants.
Main Methods:
- A retrospective single-center cohort study included 340 preterm infants (mean gestational age 30 weeks).
- Compared Fenton and IG-21st tools for classifying small for gestational age (SGA) and postnatal growth failure at discharge.
- Assessed the association between growth failure and neurodevelopmental outcomes at 12 and 24 months.
Main Results:
- High agreement (0.94) between Fenton and IG-21st for identifying small for gestational age (SGA) at birth.
- Moderate agreement (0.6) for classifying postnatal growth failure at discharge.
- Growth failure at discharge was less prevalent when using the IG-21st tool.
- Significant association found between weight-based growth failure and poorer neurodevelopmental outcomes at 12 and 24 months.
Conclusions:
- While both tools effectively identify SGA, the IG-21st tool may identify fewer cases of postnatal growth failure.
- Weight-based growth failure in preterm infants is a significant predictor of impaired neurodevelopment.
- Further research is needed to establish optimal growth monitoring strategies for preterm infants.
Abstract:
Although the survival rate of preterm infants has improved over the years, growth failure and associated impaired neurodevelopmental outcome remains a significant morbidity. Optimal nutrition plays an important role in achieving adequate postnatal growth. Accurate growth monitoring of preterm infants is critical in guiding nutritional protocols. Currently, there is no consensus regarding which growth assessment tool is suitable for monitoring postnatal growth of preterm infants to foster optimal neurodevelopmental outcomes while avoiding future consequences of aggressive nutritional approaches including increased risk for cardiovascular disease and metabolic syndrome. A retrospective single center cohort study was conducted to compare the performance of two growth-assessment tools, Fenton and Intergrowth-21st (IG-21st) in the classification of size at birth, identification of impaired growth and predicting neurodevelopment. A total of 340 infants with mean gestational age of 30 weeks were included. Proportion of agreement between the two tools for identification of small for gestational age (SGA) was high 0.94 (0.87, 0.1) however, agreement for classification of postnatal growth failure at discharge was moderate 0.6 (0.52, 0.69). Growth failure at discharge was less prevalent using IG-21st. There was significant association between weight-based growth failure and poor neurodevelopmental outcomes at 12 and 24 months of age.
