Bertino Enrico, Di Nicola Paola, Giuliani Francesca, Coscia Alessandra, Varalda Alessia, Occhi Luciana, Rossi Claudia
Neonatal Intensive Care Unit, Turin, Italy.
J Matern Fetal Neonatal Med. 2011 Oct;24 Suppl 2:9-11. doi: 10.3109/14767058.2011.601921. Epub 2011 Aug 30.
The past two decades have seen a progressive improvement in the survival rates of preterm infants, especially in neonates <30 weeks of gestational age. These neonates constitute the large majority of the population in neonatal intensive care units. The correct evaluation of postnatal growth of these babies is nowadays of primary concern, although the definition of their optimal postnatal growth pattern is still controversial. Concerns have also been raised about the strategies to monitor their growth, specifically in relation to the charts used. At present the available charts in clinical practice are fetal growth charts, neonatal anthropometric charts and postnatal growth charts for term infants. None of these, for different reasons, is suitable to correctly evaluate preterm infant growth. An international multicentric project has recently started a study aiming at building a prescriptive standard for the evaluation of postnatal growth of preterm infants and it will be available in the next years providing a population that is conceptually as close as possible to the prescriptive approach used for the construction of the WHO infant and child growth standards. At present, while an international longitudinal standard for evaluating preterm infant postnatal growth is lacking, in Italy the best compromise in clinical practice is likely to be as follows: new Italian INeS (Italian Neonatal Study) charts up to term; International longitudinal charts WHO 2006 or CDC 2002 from term to two years; finally the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP) 2006 growth charts could be suitable for monitoring the growth of these infants from two years up to 20 years of age.
在过去二十年中，早产儿的存活率有了逐步提高，尤其是孕周小于30周的新生儿。这些新生儿占新生儿重症监护病房患者的绝大多数。如今，对这些婴儿出生后生长情况的正确评估成为首要关注点，尽管其最佳出生后生长模式的定义仍存在争议。人们也对监测他们生长的策略提出了担忧，特别是与所使用的生长图表相关。目前临床实践中可用的图表有胎儿生长图表、新生儿人体测量图表和足月儿出生后生长图表。由于不同原因，这些图表都不适用于正确评估早产儿的生长情况。一个国际多中心项目最近启动了一项研究，旨在建立一个评估早产儿出生后生长情况的规范性标准，未来几年将会推出，提供一个在概念上尽可能接近用于构建世界卫生组织婴幼儿生长标准的规范性方法的群体。目前，虽然缺乏评估早产儿出生后生长情况的国际纵向标准，但在意大利，临床实践中最好的折衷办法可能如下：使用新的意大利INeS（意大利新生儿研究）图表直至足月；从足月到两岁使用世界卫生组织2006年或美国疾病控制与预防中心2002年的国际纵向图表；最后，意大利儿科内分泌与糖尿病学会（SIEDP）2006年生长图表可能适用于监测这些婴儿从两岁到20岁的生长情况。
