Use of a Body Proportionality Index for Growth Assessment of Preterm Infants

Olsen, Irene E.; Lawson, M. Louise; Meinzen‐Derr, Jareen; Sapsford, Amy L.; Schibler, Kurt; Donovan, Edward F.; Morrow, Ardythe L.

doi:10.1016/j.jpeds.2008.10.012

Cited by 54 publications

(45 citation statements)

References 27 publications

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“…[14][15][16] The incidence of fetal malnutrition in our study was 26.59% according to BMI charts which is less in comparision with studies by Soundarya et al and Thammanna et al where it was 40.3 % and 39.45% respectively. 7,8 However, in our study we have used standardized gestational age and gender specific BMI percentile curves unlike those studies.…”

Section: Discussioncontrasting

confidence: 49%

Assessment of fetal malnutrition by body mass index and intra uterine growth curves: a comparative study

Kamath¹,

Rao²,

Shenoy³

2016

Int J Contemp Pediatr

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INTRODUCTIONFetal malnutrition is a significant problem in developing countries. Of the 95.6% of the low birth weight (LBW) babies born in developing countries, India accounts for 40% (7.8 million) of LBW. These undernourished newborns are at high risk for perinatal complications like birth asphyxia, sepsis, hypoglycemia, hypocalcemia and also long term problems like decreased cognitive abilities and higher risk of diabetes and hypertension during adulthood.1 Hence, detecting under nutrition at birth becomes important so that these babies can be monitored for complications and growth failure.There are various methods which are being followed in the nurseries for nutritional assessment. The most widely used are birth weight based Intra uterine growth (IUG) charts extrapolated from various populations.2 The popular ones are the IUG charts compiled by Olsen et al and Lubchenco et al. 2,3 The most recent and reliable gender specific IUG charts are the one compiled by Olsen et al based on a large population of 391,681 racially diverse infants from 248 hospitals in the US.2 Lubchenco charts are based on data collected between 1940s and 1960s from 5000 white infants from a single NICU in Colarado.3 The growth charts compiled based on a cohort of newborns from a tertiary hospital in North India are ABSTRACT Background: Assessment of fetal malnutrition (FM) is incomplete by intra uterine growth (IUG) charts where only single anthropometric measure like weight is used. Body mass index (BMI) is a weight to length ratio which is a sensitive indicator of malnutrition. This study was aimed at comparing the accuracy of various birth weight based IUG charts with Body mass index of the new-born babies in detection of FM and correlating the neonatal complications with the BMI and the birth weight. Methods: A cohort study was done with a sample of 1192 newborn babies with gestational ages from 34 to 40 weeks. The newborns were classified based on BMI and birth weight after plotting on the BMI charts and various IUG charts. The accuracy of the various IUG charts in identifying FM when compared to BMI was analyzed and correlated with neonatal complications. Results: The prevalence of FM was 26.59% on classifying using BMI charts which was the highest when compared to the IUG charts. The IUG charts misclassified the undernourished babies as well nourished. The incidence of complications was 26.3% among the babies with low BMI when compared to normal BMI (14.8%). The classification of the newborns according to IUG charts did not correlate with incidence of complications. Conclusions: BMI chart is most sensitive indicator of FM at birth and its use is highly recommended in a developing country like India. It helps us to target the under nourished babies, provide better nutritional care and also anticipate and prevent neonatal complications.

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Section: Discussioncontrasting

confidence: 49%

Assessment of fetal malnutrition by body mass index and intra uterine growth curves: a comparative study

Kamath¹,

Rao²,

Shenoy³

2016

Int J Contemp Pediatr

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“…We believe that quantifying disproportionate growth will provide information to individualize and better target nutritional care. For example, a preterm infant whose weight is considered small for age but large for length 22 would probably benefit from a different nutrition care plan than an infant whose weight is considered small for age and length.…”

Section: Discussionmentioning

confidence: 99%

“…13,22 Although extrauterine growth restriction usually refers to weight growth restriction, it also affects head and especially length growth. 9,16,19,20 Poor growth in weight, length, or head circumference is associated with poor neurodevelopmental outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…15 However, size for age does not identify growth that is disproportionate or weight gain that might be too low or high for an infant's length. There is evidence that preterm infants experience poor growth postnatally, 9,[16][17][18][19][20][21] and upon closer look this growth failure is disproportionate between growth measures 9,20,22 : head growth is best, weight growth is slower and the focus of concern, but gain in length is slowest. 9 Currently there is no way to quantify and monitor disproportionate growth in the NICU.…”

mentioning

confidence: 99%

“…Olsen et al found that Lubchenco's ponderal index (or weight/length 3 ) provided different information about weight growth status in preterm infants than weight for age alone 22 ; for example, most of the infants categorized as small weight for age were appropriate weight for length at birth and hospital discharge. Others also have described variation in growth status assessed by weight for age versus body fat or its proxies (ie, weight-for-length ratios).…”

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confidence: 99%

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BMI Curves for Preterm Infants

et al. 2015

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BACKGROUND AND OBJECTIVES: Preterm infants experience disproportionate growth failure postnatally and may be large weight for length despite being small weight for age by hospital discharge. The objective of this study was to create and validate intrauterine weight-for-length growth curves using the contemporary, large, racially diverse US birth parameters sample used to create the Olsen weight-, length-, and head-circumference-for-age curves.METHODS: Data from 391 681 US infants (Pediatrix Medical Group) born at 22 to 42 weeks' gestational age (born in 1998-2006) included birth weight, length, and head circumference, estimated gestational age, and gender. Separate subsamples were used to create and validate curves. Established methods were used to determine the weight-for-length ratio that was most highly correlated with weight and uncorrelated with length. Final smoothed percentile curves (3rd to 97th) were created by the Lambda Mu Sigma (LMS) method. The validation sample was used to confirm results. RESULTS:The final sample included 254 454 singleton infants (57.2% male) who survived to discharge. BMI was the best overall weight-for-length ratio for both genders and a majority of gestational ages. Gender-specific BMI-for-age curves were created (n = 127 446) and successfully validated (n = 126 988). Mean z scores for the validation sample were ∼0 (∼1 SD).CONCLUSIONS: BMI was different across gender and gestational age. We provide a set of validated reference curves (gender-specific) to track changes in BMI for prematurely born infants cared for in the NICU for use with weight-, length-, and head-circumference-for-age intrauterine growth curves. WHAT'S KNOWN ON THIS SUBJECT:Preterm infants experience disproportionate growth failure postnatally and may be large weight for length despite being small weight for age by hospital discharge. There is no routinely used measure to quantify and monitor disproportionate growth in the NICU.WHAT THIS STUDY ADDS: BMI differs across gender and gestational age. We provide a set of validated reference curves to track changes in BMI for prematurely born infants for use with weight-, length-, and head-circumference-for-age intrauterine growth curves.

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Physiological responses and behavioural organization of very low birth weight infants during swaddled versus traditional weighing

Vicente‐Perez,

Robleda,

Gich

et al. 2023

Nursing Open

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AimDespite the consequences of neonatal distress and agitation, preterm infants undergo stress owing to weighing procedures. The objective of this study was to enable very low birth weight infants to maintain adequate self‐regulation during weighing.DesignThis prospective crossover study utilizes a within‐subjects design, where intervention days were compared to control days.MethodInfants were exposed to both swaddled and unswaddled weighing in an intensive care nursery setting. Nineteen very low birth weight infants were weighed on two consecutive days. Variables of heart rate, respiratory rate and ALPS‐Neo score were recorded.ResultsStress score decreased significantly from 1.65 (pre‐weight) to 0.23 (weight measurement) in swaddled‐intervention periods; conversely, it increased significantly from 1.26 (pre‐weight) to 4.97 (weight measurement) in control periods. During weight measurement, heart and respiratory rate were significantly lower for swaddled‐intervention days when compared to control days. Given the significant impact of swaddled weighing in reducing stress, this method can be used as an appropriate weighing procedure in intensive care. This research has no patient or public contribution.

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Use of a Body Proportionality Index for Growth Assessment of Preterm Infants

Cited by 54 publications

References 27 publications

Assessment of fetal malnutrition by body mass index and intra uterine growth curves: a comparative study

Assessment of fetal malnutrition by body mass index and intra uterine growth curves: a comparative study

BMI Curves for Preterm Infants

Physiological responses and behavioural organization of very low birth weight infants during swaddled versus traditional weighing

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