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Differences in Postnatal Growth of Preterm Infants in Northern China Compared to the INTERGROWTH-21st Preterm

Li Zhang1, Nan-Nan Gao1, Hui-Juan Liu1

  • 1Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China.

Frontiers in Pediatrics
|June 30, 2022
PubMed

Insights

This study developed new growth charts for preterm infants in northern China, finding they were longer and heavier than international standards. These findings highlight the need for population-specific preterm growth assessments.

Area of Science:

  • Pediatrics
  • Neonatology
  • Growth and Development

Background:

  • The INTERGROWTH-21st preterm postnatal growth standards (IPPGS) are widely used but their applicability to diverse preterm populations is debated.
  • This study addresses the need for localized growth references for preterm infants.

Purpose of the Study:

  • To formulate reference growth charts for a preterm infant cohort in northern China.
  • To compare these new charts with the existing IPPGS.

Main Methods:

  • Retrospective cohort study of 1,827 healthy preterm infants (born 2011-2021) with follow-up to 70 weeks postmenstrual age (PMA).
  • Used Generalized Additive Models for Location, Scale, and Shape to create percentile and Z-score charts for length, weight, and head circumference (HC) from 40-64 weeks PMA.
  • Calculated Z-scores (LAZ, WAZ, HCZ) and differences (dLength, dWeight, dHC) compared to IPPGS.

Main Results:

  • Preterm infants in this cohort were significantly longer and heavier than IPPGS standards (40-64 weeks PMA), with notable differences in girls' length.
  • Mean LAZ, WAZ, and HCZ were consistently above 0 compared to IPPGS, particularly LAZ and WAZ (approx. 1.0).
  • Sex differences observed: girls had larger LAZ and WAZ (early PMA), while HCZ declined with PMA for both sexes, with girls having lower HCZ after 56 weeks.

Conclusions:

  • Postnatal growth in this northern China preterm cohort exceeds IPPGS benchmarks between 40-64 weeks PMA.
  • Sex-specific variations in growth trajectories exist within this population.
  • These findings underscore the importance of developing and utilizing population-specific growth charts for preterm infants.
Abstract

Keywords:
INTERGROWTH-21stgrowth referencegrowth standardpostnatal growthpreterm infants

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