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Somatic growth failure in infants related to artifact and error
Insights
Accurate infant growth assessment requires considering gestational age. Plotting birth length by gestational age reduces erroneous diagnoses of growth failure in newborns.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Infant growth failure can be misdiagnosed due to measurement errors and artifacts.
- Standard growth charts may not adequately account for variations in gestational age among full-term infants.
Purpose of the Study:
- To evaluate the impact of considering gestational age on the interpretation of infant growth curves.
- To determine if accounting for gestational age reduces the incidence of falsely identified downward growth shifts.
Main Methods:
- Crown-heel lengths of 77 full-term newborns were measured and plotted on standard growth charts.
- Growth curves were analyzed both with and without consideration of gestational age.
- Data were compared using National Center for Health Statistics percentiles and tables by Miller and Merritt.
Main Results:
- Significantly fewer downward shifts in growth curves were observed when gestational age was considered.
- Accurate measurement of crown-heel length at birth is crucial for reliable growth assessment.
- Gestational age adjustment improves the accuracy of identifying true growth faltering.
Conclusions:
- Accurate infant growth assessment necessitates plotting birth length according to gestational age.
- Considering gestational age minimizes diagnostic confusion and potential misdiagnosis of growth failure.
- Recommendations emphasize obtaining precise measurements and utilizing gestational age-specific charts.
Abstract:
Growth failure in infants may be diagnosed erroneously because of artifact, error, or both. Assuming that all full-term infants have the same gestational age creates an artifact that is confounded further by errors in measurement of birth length. Crown-heel lengths of 77 while full-term newborns born at the University of Kansas Medical Center, Kansas City, were plotted on standard National Center for Health Statistics postnatal growth chart percentiles appropriate for sex, both with and without regard for gestational age. By the end of the first postnatal year, significantly fewer downward shifts in the growth curves occurred when fetal age was considered in the location of birth percentiles, according to tables by Miller and Merritt. To avoid confusion in interpretation of downward shifts in infants' growth patterns, we recommend that accurate crown-heel lengths be obtained at birth and plotted according to gestational age whenever possible.