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Growth outcome at 2 years using Fenton and Intergrowth-21st charts in infants less than 1500 g

Lara González García1, Enrique García López2, Belén Fernández Colomer2

  • 1Servicio de Pediatría, Hospital Vital Álvarez-Buylla, Mieres, Asturias, Spain.

Anales De Pediatria
|August 11, 2022
PubMed

Insights

Neonatal weight z-scores from Fenton and Intergrowth-21st charts effectively predict short stature and malnutrition in very low birth weight infants at two years. Both charts showed similar predictive accuracy.

Area of Science:

  • Neonatalogy
  • Pediatric Growth Monitoring
  • Public Health

Background:

  • Consensus is lacking on optimal neonatal growth charts for very low birth weight (VLBW) infants.
  • Accurate growth assessment is crucial for VLBW infants' long-term health outcomes.

Purpose of the Study:

  • To compare the predictive accuracy of Fenton 2013 and Intergrowth-21st (IW-21) charts for VLBW infant somatometry at two years.
  • To identify risk factors associated with short stature in VLBW children at two years.

Main Methods:

  • A cohort of 513 VLBW infants (born 2002-2017, mean gestational age 30.05 weeks) was analyzed.
  • Neonatal z-scores (Fenton and IW-21) were assessed for predicting short stature, head circumference deficits, and malnutrition at two years using WHO charts.

Main Results:

  • Both Fenton and IW-21 charts demonstrated utility in predicting short stature and malnutrition risk at two years, with comparable Area Under the Receiver Operating Characteristic (ROC) curves.
  • Discharge weight z-score was a significant predictor for short stature, malnutrition, and head circumference deficits at two years.
  • Prevalence rates at two years were: short stature (17.2%), head circumference <-2 DS (4.1%), and malnutrition (6.1%). Independent risk factors for short stature included low weight for gestational age and longer hospital stay.

Conclusions:

  • Discharge weight z-score serves as a reliable predictor for adverse growth outcomes (short stature, malnutrition, head circumference deficits) at two years in VLBW children.
  • No significant statistical difference was observed in the predictive performance between the Fenton and IW-21 neonatal growth charts.
Abstract

Keywords:
Catch upGrowth chartGráfica de crecimientoMuy bajo peso al nacerPrematuridadPreterm birthVery low birth weight

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