2024-08-13 / News
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Preterm birth significantly increases risks for infants, leading to immediate health issues and long-term developmental challenges. Effective growth monitoring in neonatal intensive care units (NICUs) is essential for improving outcomes, as it enables the identification of infants at risk for conditions like extrauterine growth restriction (EUGR). However, the choice of growth chart is vital for accurate assessments. A recent study highlights the challenges in monitoring extremely and very preterm neonates, revealing discrepancies between growth charts. It emphasises the need for standardised growth monitoring practices in NICUs to better support preterm infants and improve their long-term health outcomes.
A retrospective study of 462 preterm infants born before 32 weeks of gestation at the University General Hospital of Heraklion in Greece (2008-2022) examined the impact of early feeding practices on growth outcomes. Utilising the Fenton 2013 and INTERGROWTH-21st growth charts, the study assessed how different feeding strategies influenced rates of Extrauterine Growth Restriction (EUGR).
The findings revealed considerable discrepancies in the classification of SGA and EUGR depending on the growth chart used. According to the Fenton2013 growth curves, 6.3% of the neonates were classified as small for gestational age (SGA) at birth, whereas the INTERGROWTH-21st curves identified 9.3% as SGA. This discrepancy was even more pronounced at discharge, with 45.9% of neonates being classified as having EUGR based on the Fenton2013 weight curves, compared to only 29.2% with the INTERGROWTH-21st curves. These findings highlight significant differences in growth restriction prevalence depending on the growth reference used. These differences were observed through the calculation of z-scores for birth weight and weight, length, and head circumference at discharge and highlight the urgent need for scientific clarity on the most effective methods for measuring growth and making predictions.
The study also assessed the impact of nutritional practices on growth outcomes. It revealed that the timing of enteral feeding initiation and the duration of parenteral nutrition were associated with EUGR in both growth curves. Specifically, the study observed that an earlier initiation of enteral feeding and a shorter duration of parenteral nutrition were linked to better growth outcomes, reducing the prevalence of EUGR. of detailed and individualised nutritional management in the care of preterm infants.
The findings indicate a need for further evaluation of growth charts to determine the most appropriate tools for monitoring the growth of preterm infants in neonatal intensive care units. Choosing the right growth reference is crucial because an inaccurate growth chart can lead to some cases of EUGR being missed or identified too late, affecting clinical decisions and long-term health outcomes. By refining feeding plans and monitoring growth closely, healthcare providers can better manage their patients’ nutrition plans and improve their long-term health and well-being.
In summary, this research highlights the urgent need for personalised growth monitoring for preterm babies, as it is crucial for accurately tracking their development and improving care, which has important implications for how NICUs around the world manage their patients.
Full list of authors: Kakatsaki I, Papanikolaou S, Roumeliotaki T, Anagnostatou NH, Lygerou I, Hatzidaki E.
DOI: 10.3390/nu15153290