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Published on: January 12, 2018
The growth diversity of preterm infants at 0-36 months corrected age in China: a real-world observational study
Xia Wang1,2, Shuwen Feng1,2, Pu Yang1,2
1Department of Pediatrics, Women and Children's Hospital, Zhongnan Hospital, Wuhan University, Wuhan, China.
Insights
This study tracked the growth of preterm infants, revealing distinct trajectories for different gestational ages. New growth curves and percentile values offer improved assessment for this vulnerable population.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Premature birth disrupts fetal development, necessitating specialized postnatal care.
- Current growth standards for preterm infants often rely on term infant data, lacking longitudinal research.
- Postmenstrual age (PMA) of 40 weeks is a common benchmark, but dynamic growth tracking for preterm infants is underexplored.
Purpose of the Study:
- To establish longitudinal growth curves and percentile values for preterm infants.
- To analyze the dynamic postnatal growth trajectories of preterm infants up to 36 months corrected age (CA).
- To identify growth patterns and potential growth retardation in different gestational age (GA) groups.
Main Methods:
- Utilized a database of 79,514 preterm infants from China (2016-2022).
- Collected anthropometric measurements from birth to 36 months corrected age (CA).
- Employed a generalized additive model (GAM) to generate growth curves and percentile values.
Main Results:
- Birth weights for gestational age aligned with Chinese standards.
- Extrauterine growth retardation was prevalent, exceeding 10% at 40 weeks PMA in GA ≤34-week groups, and reaching 55.56% in very preterm infants (VPIs).
- Established growth curves showed late preterm infants approximated term standards, while VPIs consistently lagged behind term standards up to 36 months CA.
Conclusions:
- Preterm infants exhibit varied growth trajectories based on gestational age.
- Developed growth curves and percentile values provide a specialized tool for assessing preterm infant growth.
- These findings offer an improved method for the growth assessment of preterm infants.
Background:
Premature delivery interrupts the natural growth of the fetus. The postnatal healthy management of preterm infants still follows term standards after a postmenstrual age (PMA) of 40 weeks and there is a lack of research on the longitudinal dynamic postnatal growth tracks of preterm infants.
Methods:
Based on the database established by the Wuhan University Internet+ Early Childhood Development Alliance in China, information on preterm infants, including birth registration and health follow-ups from 2016 to 2022, was incorporated into the health management system. Standardized anthropometric measurements of preterm infants were recorded from birth to a corrected age (CA) of 36 months. A generalized additive model based on location, scale, and shape was used to establish the percentile values and growth curves.
Results:
In total, 79,514 preterm infants were included in this study, and the birth weights at each gestational age (GA) were similar to Chinese standards. When evaluated by term birth weight, we found that the proportions of extrauterine growth retardation at a PMA of 40 weeks were all above 10% in the GA ≤34-week groups and reached between 17.19% and 55.56% in very preterm infants (VPIs). There was a high incidence of preterm infants with a weight below the third percentile in VPIs when referring to term standards at CAs of 0, 6, 12, 24, and 36 months (p < 0.001). We established natural growth curves of the preterm population with different GAs between CAs of 0 and 36 months, which indicated that the weight/length of late preterm infants was close to term standards while the growth trajectory of VPIs consistently lagged behind (p < 0.001).
Conclusion:
Our study revealed the different growth trajectories of preterm infants with different GAs. A set of growth curves and percentile values for preterm infants of different GAs between CAs of 0 and 36 months were established, offering an optional method for growth assessment of this special population.
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