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Tuková J, Kosek Krásničanová H, Hladíková M, Marková D. Novel growth reference ImaGrow differed from existing charts for preterm children aged 0-2 years. Acta Paediatr 2024; 113:1818-1832. [PMID: 38516724 DOI: 10.1111/apa.17207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024]
Abstract
AIM This study aimed to address the critical need for more accurate growth reference charts for preterm infants, with a particular focus on low- and very low-birth-weight infants. METHODS The subjects were recruited at a single tertiary centre. The cohort comprised singleton and twin infants born before 37 weeks of gestation, with data collected from 2000 to 2016. Standardised measurements of body parameters were recorded in this mixed longitudinal survey. LMS method was utilised for data analysis. Statistical analysis was performed using SPSS Statistics Version 21. The validation with another new cohort was executed. RESULTS A total of 1781 infants (52.5% boys) met the inclusion criteria. The median gestational age at birth was 30 weeks, with a median birth weight of 1350 grams. The main findings included the construction of ImaGrow charts for low- and very low-birth-weight infants and significant differences in growth trajectories compared to Fenton+WHO charts. CONCLUSION Our comprehensive growth references, ImaGrow, are based on a long-term auxological assessment of preterm infants and differ from charts derived from size-at-birth standards or charts for term babies. These charts have significant implications for clinical practice in monitoring and assessing the growth of preterm infants.
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Affiliation(s)
- Jana Tuková
- Department of Paediatrics and Inborn Metabolic Diseases, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Hana Kosek Krásničanová
- Department of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marie Hladíková
- Department of Paediatrics and Inborn Metabolic Diseases, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Daniela Marková
- Department of Paediatrics and Inborn Metabolic Diseases, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Gounaris AK, Sokou R. Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes. Nutrients 2024; 16:218. [PMID: 38257111 PMCID: PMC10819760 DOI: 10.3390/nu16020218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
The Special Issue has been completed with the publication of 13 review and research articles [...].
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Affiliation(s)
- Antonios K. Gounaris
- Neonatal Intensive Care Unit, University Hospital of Larissa, 413 34 Larissa, Greece;
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, Nikea General Hospital “Agios Panteleimon”, 184 54 Piraeus, Greece
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Kakatsaki I, Papanikolaou S, Roumeliotaki T, Anagnostatou NH, Lygerou I, Hatzidaki E. The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors. Nutrients 2023; 15:3290. [PMID: 37571226 PMCID: PMC10420820 DOI: 10.3390/nu15153290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Monitoring the growth of neonates in the Neonatal Intensive Care Unit (NICU) using growth charts constitutes an essential part of preterm infant care. Preterm infants are at increased risk for extrauterine growth restriction (EUGR) due to increased energy needs and clinical complications. This retrospective study compares the prevalence of small for gestational age (SGA) at birth and EUGR at discharge in extremely and very preterm neonates hospitalized in the NICU of a tertiary hospital in Greece, using different growth curves, and it examines the associated nutritional and clinical factors. Fenton2013 and INTERGROWTH-21st growth curves were used to calculate z-scores of birth weight (BW) and weight, length, and head circumference at discharge. The study includes 462 newborns with a mean BW of 1341.5 g and mean GA of 29.6 weeks. At birth, 6.3% of neonates were classified as SGA based on Fenton2013 curves compared to 9.3% with INTERGROWTH-21st growth curves. At discharge, 45.9% of neonates were characterized as having EUGR based on the Fenton2013 weight curves and 29.2% were characterized based οn INTERGROWTH-21st curves. Nutritional factors such as the day of initiation, attainment of full enteral feeding, and the duration of parenteral nutrition were associated with EUGR by both curves. The prevalence of SGA and EUGR neonates differs between the two growth references. This shows that further evaluation of these charts is needed to determine the most appropriate way to monitor infant growth.
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Affiliation(s)
- Ioanna Kakatsaki
- Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece; (I.K.); (S.P.); (N.H.A.); (I.L.)
| | - Styliani Papanikolaou
- Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece; (I.K.); (S.P.); (N.H.A.); (I.L.)
| | - Theano Roumeliotaki
- Clinic of Preventive Medicine and Nutrition, Division of Social Medicine, School of Medicine, University of Crete, 70013 Crete, Greece;
| | - Nicolina Hilda Anagnostatou
- Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece; (I.K.); (S.P.); (N.H.A.); (I.L.)
- Neonatology, School of Medicine, University of Crete, 70013 Crete, Greece
| | - Ioanna Lygerou
- Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece; (I.K.); (S.P.); (N.H.A.); (I.L.)
| | - Eleftheria Hatzidaki
- Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece; (I.K.); (S.P.); (N.H.A.); (I.L.)
- Neonatology, School of Medicine, University of Crete, 70013 Crete, Greece
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Lucaccioni L, Iughetti L, Berardi A, Predieri B. Challenges in the growth and development of newborns with extra-uterine growth restriction. Expert Rev Endocrinol Metab 2022; 17:415-423. [PMID: 35941822 DOI: 10.1080/17446651.2022.2110468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/03/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Extra-uterine growth restriction (EUGR) is a condition caused by the failure of very preterm infants to reach their potential growth during the NICU hospital stay. Despite enormous improvements in nutritional support and strategies, the growth pattern of preterm infants is still far from the one expected. AREAS COVERED This review focuses on what EUGR is, highlighting controversial aspects of this topic. EUGR is still missing a univocal definition, and the international debate is also open on what is the best growth chart to use. Moreover, professionals in NICU may not be trained on how to perform anthropometric measurements, increasing the risk of over- or underestimation, especially for length assessment. EUGR has recently been described as one of the main comorbidities in NICU, influencing growth, metabolism, and neurodevelopment later in life. EXPERT OPINION There is still much to investigate about what the best growth pattern in the NICU should be. What is known so far is that the majority of preterm neonates develop EUGR, and this leads to several short- and long-term consequences. It is imperative that neonatologists and pediatric endocrinologists work together, to modulate growth in the NICU.
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Affiliation(s)
- Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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Zhang L, Gao NN, Liu HJ, Wu Q, Liu J, Zhang T, Sun J, Qi JH, Qiao XY, Zhao Y, Li Y. Differences in Postnatal Growth of Preterm Infants in Northern China Compared to the INTERGROWTH-21st Preterm Postnatal Growth Standards: A Retrospective Cohort Study. Front Pediatr 2022; 10:871453. [PMID: 35769217 PMCID: PMC9234397 DOI: 10.3389/fped.2022.871453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The INTERGROWTH-21st preterm postnatal growth standards (IPPGS) have increasingly been used to evaluate the growth of preterm infants worldwide. However, the validity of IPPGS's application to specific preterm populations remains controversial. This retrospective cohort study aimed to formulate reference growth charts for a preterm cohort in northern China and compare them to the IPPGS. METHODS A total of 1,827 healthy preterm infants with follow-up visits before 70 weeks of postmenstrual age (PMA) were retrospectively sampled from a preterm cohort (N = 2,011) born between 1 January 2011 and 28 February 2021, at the First Affiliated Hospital of Shandong First Medical University. Using the Generalized Additive Models for Location, Scale, and Shape method, 5,539 sets of longitudinal data were used to construct percentile and Z-score charts of length, weight, and head circumference (HC) at 40-64 weeks of PMA. Z-scores of length, weight, and HC (LAZ, WAZ, and HCZ) before 64 weeks were calculated using the IPPGS. Differences in the 50th percentile values between preterm infants and IPPGS (dLength, dWeight, and dHC) were calculated. Z-scores were assigned to six PMA clusters: 40-44, 44-48, 48-52, 52-56, 56-60, and 60-64 weeks for comparison between sexes. RESULTS For eligible infants, the mean PMA and weight at birth were 33.93 weeks and 2.3 kg, respectively. Boys, late preterm infants, twins, and infants with exclusively breastfeeding accounted for 55.8, 70.6, 27.8, and 45.9%, respectively. Compared to IPPGS, preterm infants were longer and heavier, especially for dLength in girls (range, 2.19-2.97 cm), which almost spanned the 50th and 90th percentiles of IPPGS. The dHC tended to narrow with PMA for both sexes. The mean LAZ, WAZ, and HCZ of both sexes at all PMA clusters were >0, especially for LAZ and WAZ (about 1.0 relative to IPPGS), indicating higher levels than the IPPGS at 40-64 weeks. Girls had larger LAZ at each PMA cluster, larger WAZ at 40-44 weeks, and lower HCZ after 56 weeks than boys. HCZ declined with PMA for both sexes. CONCLUSION Postnatal growth of this preterm cohort was considerably higher than that of the IPPGS at 40-64 weeks of PMA with sex differences.
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Affiliation(s)
- Li Zhang
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Nan-Nan Gao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Hui-Juan Liu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Qiong Wu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Ju Liu
- Medical Research Center, Institute of Microvascular Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Ting Zhang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Jin Sun
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Jian-Hong Qi
- Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiu-Yun Qiao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yan Zhao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yan Li
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
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