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Standards for evaluating neonatal growth outcomes using individualized pathological growth potential realization
Russell L Deter1, Wesley Lee1, Roberto Romero2
1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
Insights
This study establishes standards for identifying neonatal growth abnormalities using the average pathological Growth Potential Realization Index (av. pGPRI). These standards help classify growth outcomes based on individualized growth potentials, aiding in early detection of potential issues.
Area of Science:
- Neonatalogy
- Pediatric Growth Monitoring
- Biometry
Background:
- Accurate assessment of neonatal growth is crucial for identifying potential health issues early.
- Existing methods may lack precision in quantifying deviations from expected growth trajectories.
- Individualized Growth Assessment (IGA) offers a personalized approach to monitoring growth patterns.
Purpose of the Study:
- To establish reference standards for detecting neonatal growth abnormalities.
- To introduce and validate the average pathological Growth Potential Realization Index (av. pGPRI) as a quantitative measure of growth pathology.
- To provide a framework for classifying neonatal growth outcomes based on individualized growth potentials.
Main Methods:
- Individualized Growth Assessment (IGA) was applied to 117 neonates with normal growth outcomes.
- Growth Potential Realization Index (GPRI) values were calculated using predicted and actual birth measurements derived from Rossavik size models.
- Average pathological Growth Potential Realization Index (av. pGPRI) was computed using two sets of measurements: Weight (WT), Head Circumference (HC), Chest Circumference (CHL) and WT, HC, Abdominal Circumference (AC), Thigh Circumference (ThC), CHL.
Main Results:
- The 95% reference range for av. +pGPRI in the WT, HC, CHL set was 0% to +0.50%.
- The 95% reference range for av. -pGPRI in the WT, HC, CHL set was 0% to -0.40%.
- In the more comprehensive WT, HC, AC, ThC, CHL set, the 95% reference ranges were 0% to +0.50% for av. +pGPRI and 0% to -0.72% for av. -pGPRI.
Conclusions:
- Standards are provided for classifying neonatal growth outcomes.
- The av. pGPRI serves as a parameter quantifying growth pathology based on individualized growth potentials.
- These standards facilitate the detection of neonatal growth abnormalities.
Objective:
Provide standards for detecting neonatal growth abnormalities with the average pathological Growth Potential Realization Index (av. pGPRI).
Methods:
Individualized Growth Assessment (IGA) evaluations of 117 neonates with normal growth outcomes were carried out using measurements of WT, HC, AC, ThC and CHL. Growth Potential Realization Index (GPRI) values for each parameter were calculated from predicted and actual birth measurements, the former obtained using Rossavik size models derived from the second-trimester growth potential estimates. Subtraction of either the upper and lower boundaries of GPRI reference ranges from these GPRI measurements gave + pGPRI and - pGPRI measurements. GPRI's within their reference ranges were assigned pGPRI values of zero. Average values for these two types of pGPRI's were calculated for the WT, HC, CHL set (n = 117) and the WT, HC, AC, ThC, CHL set (n = 112).
Results:
The 95% reference ranges for the av. +pGPRI's and av. -pGPRI's in the WT, HC, CHL set were 0% to +0.50% and 0% to -0.40%, respectively. In the WT, HC, AC, ThC, CHL set, the comparable results were 0% to +0.50% and 0% to -0.72%.
Conclusion:
Standards are provided for classifying neonatal growth outcomes with a parameter quantifying growth pathology that was based on individualized growth potentials.
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