Equations to support predictive automated postnatal growth curves for premature infants

Abstract

Growth charts are used in pediatric medicine to plot anthropomorphic measurements over time, serving as a screen for diseases related to a patient's nutritional and general health status. Whereas reference data for term infants are available from the Center for Disease Control, reference data for premature infants in a neonatal intensive care unit have not been established. Predictive curves for preterm patients, which are based on a patient's postmenstrual age and anthropomorphic measurements at birth, cannot be easily implemented with traditional paper-based methods. Preterm growth charts can be generated in an electronic health record system, but doing so requires mathematical equations or computer-readable tables. This report examines published perinatal growth curves and presents equations for predicted postnatal weight, head circumference and length in preterm infants.

Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National hospital in Dar-es-salaam, Tanzania from September 2018 to February 2019

“…The overall proportion of preterm with poor weight gain observed in this study was high. Furthermore the observed average weight gain is below the goal for preterm weight gain (≥ 15 grams/kg/day) estimated to replicate the growth velocity of a normal foetus during third trimester of pregnancy (4,(11)(12)(13)(14). Poor weight gain was observed more among early preterm compared to late preterm infants, although this was not statistically signi cant, it may be a re ection of poor feeding as a result of feeding intolerance and also the practice in our unit during the study period of delaying initiation of feeds for at least 24 hours for this category of neonates.…”

“…Postnatal growth pattern in preterm and LBW neonates is often characterized by initial physiological weight loss in the rst 7 days of life of approximately 7-15% of their birth weight. Thereafter recovery occurs with increase in body weight from around 10 th to 21 st day of life (3,4). However, differences in weight trends have been observed with respect to the age of the preterm, being more marked amongst early and extreme preterm as compared to late preterm (5).…”

Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National Hospital in Dar-es-salaam, Tanzania: a prospective cohort study

“…The overall proportion of preterm with poor weight gain observed in this study was high. Furthermore the observed average weight gain is below the goal for preterm weight gain (≥ 15 g/kg/day) estimated to replicate the growth velocity of a normal foetus during third trimester of pregnancy [ 4 , 11 – 14 ]. Poor weight gain was observed more among early preterm compared to late preterm infants, although this was not statistically significant, it may be a reflection of poor feeding as a result of feeding intolerance and also the practice in our unit during the study period of delaying initiation of feeds for at least 24 h for this category of neonates.…”

“…Postnatal growth pattern in preterm and LBW neonates is often characterized by initial physiological weight loss in the first 7 days of life of approximately 7-15% of their birth weight. Thereafter recovery occurs with increase in body weight from around 10th to 21st day of life [3,4]. However, differences in weight trends have been observed with respect to the age of the preterm, being more marked amongst early and extreme preterm as compared to late preterm [5].…”

Calculating postnatal growth velocity in very low birth weight (VLBW) premature infants

“…A non-linear model by Riddle et al 20 was demonstrated to be extremely accurate in predicting growth in NICU infants. This model very closely fit growth patterns from NICU infants with BW 500–2700g using a piecewise function consisting of a parabola from birth until regaining BW and an exponential function after regaining BW.…”