Conceptual issues related to the construction of prescriptive standards for the evaluation of postnatal growth of preterm infants

Villar, José; Knight, HE; Onís, Mercedes de; Bertino, Enrico; Gilli, Giorgio; Papageorghiou, Aris T.; Ismail, Leila Cheikh; Barros, F. C.; Bhutta, Zulfiqar Ahmed

doi:10.1136/adc.2009.175067

Cited by 57 publications

(43 citation statements)

References 49 publications

(41 reference statements)

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“…20,21 In addition, it should be acknowledged that the SAP standards we have used since the 70s did not regard obesity as a prevalent issue in this population. 22 The WHO is focused on developing growth standards for preterm infants with prescriptive guidelines based on the discrepancies observed in growth assessments in this risk group; 23,24 however, no data have been published to date. Although there are some reports available that show some results obtained with a similar project, 25,26 we still have doubts regarding the feasibility of finding a "healthy" preterm population that could serve as control, especially if they were born before reaching 28 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

Post discharge growth assessment in preterm infants. Implications of adopting the WHO standards

2014

Arch Argent Pediat

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Introduction.The WHO standards have been used as a gold standard for growth assessment in preterm infants since 1986. The introduction of the WHO standards in Argentina could improve detection of sub-optimal growth. Objective. To compare the proportion of growth retardation in terms of weight, body height and head circumference in preterm infants with a birth weight less than 1500 g (VLBW) assessed according to the WHO standards and the Sociedad Argentina de Pediatría (SAP) standards. Population and methods. Cohort study in VLBW newborn infants. Measurements included were weight, height and head circumferences measured at 40, 53, 66, 79 and 92 postmenstrual weeks (±1 week). Sex was recorded as an independent outcome measure for both standards (WHO and SAP). Mean Z scores were analyzed for both standards using Student's test, and the difference of proportions was assessed using the c2 test (OR; 95% CI). Results. Two hundred and four infants were included. No differences were observed in anthropometric outcome measures at birth by sex. A greater growth was seen in terms of weight and height as per the SAP standards compared to the WHO standards, which was more marked in male infants than female infants, and which diminished around their first year of life. Growth retardation in terms of height was observed in both males and females assessed with the WHO standards. No differences were observed in head circumference. A higher proportion of patients with a weight below 2 standard deviations at 3 months old was found as per the WHO (p < 0.01; OR: 0.36; 95% CI: 0.15-0.78), but that was not the case with height and head circumference. Conclusions. This study allows to suggest that changing the standards does not imply a significant modification in our follow-up practice over the first year of life of an infant.

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Section: Discussionmentioning

confidence: 99%

Post discharge growth assessment in preterm infants. Implications of adopting the WHO standards

2014

Arch Argent Pediat

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“…Com a versão atualizada, é possível avaliar RNs a partir de 22 semanas de gestação e até 10 semanas após o termo (9). A desvantagem desse tipo de curva recai no fato de que crianças nascidas prematuras geralmente são menores do que fetos da mesma IG que nascerão a termo (11)(12)(13).…”

Section: Curvas De Crescimento Para Prematurosunclassified

“…Esse novo modelo propõe uma curva multiétnica e conceitualmente muito próxi-ma às novas curvas da Organização Mundial de Saúde (OMS) (13,18).…”

Section: Curvas De Crescimento Para Prematurosunclassified

Crescimento de crianças nascidas prematuras

Cardoso-Demartini

Bagatin

Silva

et al. 2011

Arq Bras Endocrinol Metab

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SUMÁRIOCrianças nascidas prematuras podem passar por um período de restrição do crescimento logo após o nascimento. A normalização do crescimento tem início nos primeiros meses de vida, podendo ocorrer de forma lenta e progressiva. Muitas vezes essas crianças mantêm-se mais baixas e com menor peso durante toda a infância quando comparadas àquelas nascidas a termo. Em alguns casos, a recuperação completa só ocorre na adolescência. Entretanto, algumas crianças não conseguem recuperar totalmente o ganho de peso e altura, e adultos nascidos prematuros apresentam maior risco de baixa estatura. O comprometimento do crescimento é mais significativo naquelas nascidas prematuras e pequenas para a idade gestacional. Fatores como estatura-alvo, peso ao nascimento, idade gestacional, intercorrências neonatais e escolaridade materna interferem no potencial de crescimento. Especial atenção deve ser dada aos nascidos prematuros durante todo o período de crescimento. Arq Bras Endocrinol Metab. 2011;55(8):534-40 Descritores Crescimento; recém-nascido prematuro; prematuridade; baixo peso ao nascimento; pequeno para a idade gestacional; recuperação do crescimento; curvas de crescimento SUMMARY Children born prematurely might experience a period of growth restriction just after birth. Catch-up growth begins during the first months of life and can be slow and progressive. These children may remain shorter and thinner throughout infancy and childhood compared to children born at term. In some cases, complete catch-up growth occurs only during adolescence. However, some children do not completely recover growth, and adults born prematurely are at increased risk of short stature. Impaired growth is more frequent in those born preterm and small for gestational age. Factors such as target height, birth weight, gestational age, neonatal morbidities and maternal education interfere in growth potential. Special attention should be given to children born preterm during the whole growth period. Arq Bras Endocrinol Metab. 2011;55(8):534-40 Keywords Growth; preterm newborn; premature children; low birthweight; prematurity; small for gestational age; catch-up growth INTRODUÇÃO A tualmente, cerca de 13 milhões de crianças nascem prematuramente em todo o mundo e o número de partos prematuros tem aumentado nos últimos anos (1). A melhoria da assistência obstétrica e o aumento do número de gestações múltiplas, provavelmente em decorrência das técnicas de reprodução assistida, são alguns fatores que contribuem para esse aumento. Dos óbitos que ocorrem no período neonatal, não relacionados a malformações congênitas, 28% resultam de nascimentos prematuros. Estima-se um gasto de mais de 26 bilhões de dólares apenas nos Estados Unidos com problemas relacionados à prematuridade (1).A etiologia da prematuridade é multifatorial e varia de acordo com a idade gestacional (IG). Aproximadamente 14% dos casos podem ser explicados por fatores maternos e 11% por fatores genéticos fetais (2). Infecções maternas predominam como causa de nascimento

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“…7 Asimismo, los criterios auxológicos para la definición y la construcción de curvas de referencia han evolucionado a nuevos criterios. 8 Cuando se elaboraron esas curvas, la supervivencia de los niños prematuros extremos (nacidos antes de la semana 28) era muy baja y no se disponía de la infraestructura y los tratamientos del presente. "Actualmente, la disponibilidad de nuevas terapéuticas, la creciente complejidad de las unidades de cuidados intensivos, la especialización en Neonatología y aún las subespecialidades de la misma han permitido la supervivencia de niños nacidos a las 24 o 25 semanas con algo más de 500 gramos al nacimiento".…”

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