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Updated: Jun 9, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Preterm growth assessment: the latest findings on age correction
Seham Elmrayed1, Susan Dai2, Abhay Lodha2,3,4,5
1Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt. seham.elmrayed@aucegypt.edu.
Insights
Age correction is crucial for assessing growth in extremely and very preterm infants. Using corrected age ensures accurate measurements of weight, height, and head circumference up to 36 months.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Biostatistics
Background:
- Extremely preterm (<28 weeks) and very preterm (28 to <32 weeks) infants often experience growth deviations.
- Accurate growth assessment is vital for monitoring health outcomes in this vulnerable population.
- Current growth charts may not adequately account for the unique developmental trajectory of preterm infants.
Purpose of the Study:
- To determine the impact of age correction on growth assessments for preterm infants.
- To evaluate the differences between chronological and corrected age in growth parameter evaluation.
- To establish the necessity of age correction for preterm infant growth monitoring up to 36 months.
Main Methods:
- Longitudinal analysis of data from the Preterm Infant Multicenter Growth Study (2001-2014).
- Inclusion of 1,416 preterm infants with a median gestational age of 27 weeks.
- Comparison of z-scores for weight, height, and head circumference using both chronological and corrected ages at multiple time points (0, 4, 8, 21, and 36 months).
Main Results:
- Chronological age-based z-scores were consistently lower than corrected age-based z-scores, with length z-scores at term differing by up to -5.2.
- Significant misclassification of growth occurred when using chronological age: up to 72.9% misdiagnosed as stunted and 89.8% as underweight at term.
- The discrepancies highlight the potential for underestimation of growth in preterm infants without age correction.
Conclusions:
- Age correction is essential for accurate growth assessment in extremely and very preterm infants.
- Growth measures including weight, height, and head circumference require age correction through 36 months corrected age.
- Failure to implement age correction can lead to misinterpretation of growth status and potentially impact clinical management.
Objective:
To evaluate the effect of age correction up to 36 months of age for growth assessments of extremely preterm (<28 weeks) and very preterm (28 to <32 weeks) infants.
Study Design:
This longitudinal analysis used data from the Preterm Infant Multicenter Growth Study (2001-2014).
Results:
1,416 children were included (Median gestational age = 27 weeks). Chronological age-based weight, height, and head circumference z-scores were consistently lower than those based on corrected age for all ages (0, 4, 8, 21 and 36 months) by up to -5.2 (95% confidence interval -5.4, -5.1) z-scores for length at term. Using chronological age, higher proportions of children were misclassified as having suboptimal growth (up to 72.9% misdiagnosed as stunted and 89.8% misdiagnosed as underweight at term).
Conclusion:
For extremely and very preterm children, age correction is required for all growth measures through 36 months of corrected age.
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