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[Birth weight percentiles of premature infants needs to be updated]
A L Kwan1, S P Verloove-Vanhorick, R A Verwey
1Ziekenhuis Bronovo, afd. Verloskunde en Gynaecologie, s-Gravenhage.
Insights
Kloosterman charts for preterm infant birthweight are outdated. The 1983 data show significant shifts, with more small-for-gestational age infants than expected, necessitating updated birthweight percentiles for preterm births.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Growth Standards
Context:
- The study examines the continued relevance of historical Kloosterman charts (1931-1965) for assessing preterm infant birthweight.
- Utilizes data from the 1983 'project of the premature and small for gestational age' (POPS) survey in the Netherlands.
- Focuses on a cohort of 855 Caucasian infants born between 24-31 weeks of gestation.
Purpose:
- To determine if conventional Kloosterman charts for preterm birthweight remain valid in contemporary obstetrics.
- To analyze current birthweight distribution patterns in preterm infants compared to historical standards.
- To identify the need for updated reference charts for preterm infant growth.
Summary:
- Analysis of 1983 POPS survey data revealed significant deviations from historical Kloosterman charts.
- A higher-than-expected percentage of small-for-gestational age infants and a lower percentage of large-for-gestational age infants were observed across most gestational age categories.
- These discrepancies persisted even after excluding elective births, indicating a fundamental shift in birthweight distribution.
Impact:
- Suggests that changes in obstetric practices have altered preterm infant birthweight patterns.
- Highlights the critical need to update birthweight percentiles for preterm infants to ensure accurate growth assessment.
- Informs clinical practice and future research on optimal fetal growth monitoring in preterm populations.
Objective:
To analyse whether the conventional so-called Kloosterman charts for birthweight of preterm infants based on data from 1931-1965 are still valid.
Design:
Descriptive investigation.
Location:
The Netherlands.
Method:
Data were obtained from the 'project of the premature and small for gestational age' (POPS) survey in 1983. The population consisted of 855 Caucasian infants born after a pregnancy of 24-31 weeks.
Results:
In nearly all gestational age categories the percentages of small-for-gestational age infants were higher than the 10% they should have been by definition; the percentages of large-for-gestational age infants were much lower than 10%. After exclusion of elective births the percentages remained different.
Conclusion:
These shifts in the birthweight distribution are probably the result of changes in obstetrics. The birthweight percentiles for preterm births will have to be updated.