We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Individualized Postnatal Growth Trajectories for Preterm Infants.
- Authors
Landau-Crangle, Erin; Rochow, Niels; Fenton, Tanis R.; Kai Liu; Anaam Ali; Hon Yiu So; Fusch, Gerhard; Marrin, Michael L.; Fusch, Christoph
- Abstract
Background: Growth of preterminfants is monitored using fetal charts despite individual trajectories being downshifted postnatally by adaptational processes. The study aims to compare different approaches to create individualized postnatal trajectories. Methods: Three approaches to achieve growth similar to healthy term infants at 42+0/7 weeks postmenstrual age (PMA) on World Health Organization growth standards (WHOGS) (target weight) were tested by comparing trajectories obtained by: 1) following birth percentiles (Birth-Weight-Percentile Approach); 2) following percentiles achieved at day of life 21 (Postnatal-Percentile Approach); 3) using day-specific fetal median growth velocities starting at day of life 21 (Fetal-Median-Growth Approach [FMGA]). The primary outcome was delta weight (ΔW), defined as difference between target weight (WHOGS) at 42+0/7 weeks and weight predicted by trajectories. The secondary outcome was ΔW vs %fat mass in a cohort of 20 disease-free surviving very low-birth-weight infants. Results: Birth-Weight-Percentile and Postnatal-Percentile Approach showed high ΔW; FMGA alone reduced ΔW. Introducing a factor to FMGA to reflect the transition to extrauterine conditions (Growth-Velocity Approach [GVA]) minimized ΔW. GVA merged with target and best normalized for body composition related to ΔW. Conclusions: GVA provides an evidence-based approach for individualized growth trajectories. GVA is based on physiologic data and that healthy preterm infants adjust their postnatal trajectory below their birth percentile. GVA may reflect a biologic principle because it matches consistently with WHOGS at 42+0/7 weeks for all preterm infants from 24 to 34 weeks. This concept could become a bedside tool to aid clinicians in monitoring growth, guiding nutrition, and minimizing chronic adult disease risks as a consequence of unguided, inappropriate growth.
- Subjects
PREMATURE infant nutrition; GROWTH in premature infants; BIRTH weight; CHRONIC disease risk factors; WORLD Health Organization
- Publication
JPEN Journal of Parenteral & Enteral Nutrition, 2018, Vol 42, Issue 5, p1084
- ISSN
0148-6071
- Publication type
Article
- DOI
10.1002/jpen.1138