Comparison of Postnatal Growth Charts of Singleton Preterm and Term Infants Using World Health Organization Standards at 40–160 Weeks Postmenstrual Age: A Chinese Single-Center Retrospective Cohort Study

Frontiers in Pediatrics

Hui-Juan Liu¹  Jin Sun¹  Yuan Cao¹  Yan Li¹  Qiong Wu¹  Xiang-Deng Cheng¹  Li Zhang¹  Nan-Nan Gao¹  Jian-Gong Lin²  Hui-Yun Zhang³  Shuang Liang⁴ 

[1] Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China;Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China;Department of Pediatrics, Maternal and Child Health Care Hospital of Shandong Province, Jinan, China;Department of Pediatrics, The Second Hospital of Shandong University, Jinan, China;

关键词: preterm infants;    term infants;    singleton;    postnatal growth;    growth assessment;    growth charts;    WHO standards;   

DOI  :  10.3389/fped.2021.595882

来源: Frontiers

【 摘 要 】

There remains controversy regarding whether the growth charts constructed from data of term infants, such as those produced by the World Health Organization (WHO) standards, can appropriately evaluate the postnatal growth of preterm infants. This retrospective cohort study, conducted in the First Affiliated Hospital of Shandong First Medical University in Jinan China, aimed to compare the postnatal growth charts of singleton preterm and term infants using WHO standards at 40–160 weeks postmenstrual age (PMA). A total of 5,459 and 15,185 sets of longitudinal measurements [length/height, weight, head circumference (HC), and body mass index (BMI)] from birth to 160 weeks PMA were used to construct growth charts for 559 singleton preterm (mean PMA at birth, 33.84 weeks) and 1,596 singleton term infants (born at 40 weeks PMA), respectively, using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) method. Z-scores (prematurity corrected) were calculated using WHO Anthro software. Compared to WHO standards, all parameters of preterm infants were increased, especially in terms of length/height and weight; the gap between the two almost spanned two adjacent centile curves. Compared to term controls, the length/height, weight, and BMI of preterm infants were higher at 40 weeks PMA, surpassed by term infants at 52–64 weeks PMA, and quite consistent thereafter. The HC of preterm infants at 40–160 weeks PMA was quite consistent with both term controls and the WHO standards. The Z-scores for length/height, weight, and BMI of preterm infants relative to the WHO standards gradually decreased from 1.20, 1.13, and 0.74 at 40–44 weeks PMA to 0.67, 0.42, and 0.03 at 132–160 weeks PMA, respectively; Z-scores for HC of preterm infants rapidly decreased from 0.73 to 0.29 at 40–50 weeks PMA, and then fluctuated in the range of 0.08–0.23 at 50–160 weeks PMA. Preterm infants had higher growth trajectories than the WHO standards and similar but not identical trajectories to term infants during the first 2 years of life. These findings reemphasize the necessity of constructing local growth charts for Chinese singleton preterm infants.

【 授权许可】

CC BY