Crescimento de recém-nascidos pré-termo

Abstract

At the end of the 19th century and beginning of the 20th century, Stephane Tarnier (1828-1897) and his student Pierre Budin (1846Budin ( -1907, both obstetricians at L´Hôpital Maternité de Paris, attempted to systematize the care provided to preterm newborns. 1 In their lessons, which I recommend reading, they showed concern with thermal control, prevention of infections and nutrition. Nutritional adequacy should be checked by weight gain. 1 Budin believed these infants should have a growth rate similar to that of intrauterine growth. After more than one century, these principles have not become old-fashioned.I n t h e m i d -2 0 t h c e n t u r y , intrauterine growth curves were created, and seminal data collected by Lubchenco et al. between 1948 and 1961 were published. 2 With the passing of time, several other intrauterine growth curves were published and several aspects began to be considered. Quite often, it was considered that curves were built from births and, consequently, they should not represent unborn infants. A cross-sectional study design was used, in which the data were collected from different sources, with sample sizes that were not always appropriate, and in which it was difficult to establish the correct gestational age, different races and even considerations about the effect of the altitude where the data were collected. 3 Despite much criticism, these curves provided a lot of information. An important fact is that it was difficult to achieve the growth planned for preterm infants. By comparing the growth of preterm infants with that of the intrauterine fetus, one notes that most preterm infants, even those with appropriate-for-gestational-age weight, have an initial weight loss that places them below the 10th percentile, which characterizes dietary restriction. 4 Still