BMC Pediatrics· 2013Q1· Review
A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants
- 2,683citations
- Q1SCImago
- 2013year
Short summary
A revised Fenton growth chart harmonizes preterm infant growth data with WHO standards, smoothing transitions and using actual age for more accurate monitoring.
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Key points
- Revised Fenton growth chart harmonizes preterm data with WHO Growth Standard.
- Chart uses actual age (not completed weeks) on the x-axis.
- Data smoothed between 22 and 50 weeks post-menstrual age.
- Based on meta-analysis of 3,986,456 births (34,639 < 30 weeks) from six countries.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: The aim of this study was to revise the 2003 Fenton Preterm Growth Chart, specifically to: a) harmonize the preterm growth chart with the new World Health Organization (WHO) Growth Standard, b) smooth the data between the preterm and WHO estimates, informed by the Preterm Multicentre Growth (PreM Growth) study while maintaining data integrity from 22 to 36 and at 50 weeks, and to c) re-scale the chart x-axis to actual age (rather than completed weeks) to support growth monitoring. METHODS: Systematic review, meta-analysis, and growth chart development. We systematically searched published and unpublished literature to find population-based preterm size at birth measurement (weight, length, and/or head circumference) references, from developed countries with: Corrected gestational ages through infant assessment and/or statistical correction; Data percentiles as low as 24 weeks gestational age or lower; Sample with greater than 500 infants less than 30 weeks. Growth curves for males and females were produced using cubic splines to 50 weeks post menstrual age. LMS parameters (skew, median, and standard deviation) were calculated. RESULTS: Six large population-based surveys of size at preterm birth representing 3,986,456 births (34,639 births < 30 weeks) from countries Germany, United States, Italy, Australia, Scotland, and Canada were combined in meta-analyses. Smooth growth chart curves were developed, while ensuring close agreement with the data between 24 and 36 weeks and at 50 weeks. CONCLUSIONS: The revised sex-specific actual-age growth charts are based on the recommended growth goal for preterm infants, the fetus, followed by the term infant. These preterm growth charts, with the disjunction between these datasets smoothing informed by the international PreM Growth study, may support an improved transition of preterm infant growth monitoring to the WHO growth charts.
The authors' abstract, as published at the source. BMC Pediatrics, 2013 · DOI ↗
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Field: Obstetrics and Gynecology
Obstetrics and GynecologyMedicine