Bertino Enrico, Di Nicola Paola, Varalda Alessia, Occhi Luciana, Giuliani Francesca, Coscia Alessandra
Cattedra di Neonatologia, Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università degli Studi di Torino, Torino, Italy.
J Matern Fetal Neonatal Med. 2012 Apr;25 Suppl 1:67-9. doi: 10.3109/14767058.2012.664889. Epub 2012 Mar 12.
The ability to recognize abnormal growth at birth and/or an intrauterine malnutrition is of great importance for neonatal care and prognosis. The current gold standard in neonatal auxological evaluation is based on information obtained from both neonatal anthropometric charts and intrauterine growth charts. Numerous charts have been proposed, but they are hardly comparable with each other, due to numerous methodological problems. The Italian Society of Neonatology, the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Medical Statistics and Clinical Epidemiology promoted a multicenter survey with the aim to produce an Italian neonatal anthropometric reference (Italian Neonatal Study [INeS] charts) fulfilling the set of the criteria that a reliable neonatal chart should possess. In clinical practice neonatal charts have some limitations if they are used to monitor postnatal growth of preterm newborns from birth to term. To overcome the problems related to the construction and use of a reference, an international project has recently started a study aiming to create prescriptive standard for the evaluation of postnatal growth of preterm infants (INTERGROWTH-21st). While an international longitudinal standard for evaluating preterm infant postnatal growth is lacking, in Italy the best compromise is likely to be as follows: new INeS charts up to term; International longitudinal charts WHO 2006 or CDC 2002 from term to 2 years; finally, the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP) growth charts could be suitable for monitoring the growth of these infants from 2 years up to 20 years of age.
出生时识别异常生长和/或宫内营养不良的能力对于新生儿护理和预后至关重要。目前新生儿体格评估的金标准基于从新生儿人体测量图表和宫内生长图表获得的信息。已经提出了许多图表，但由于众多方法学问题，它们彼此之间难以比较。意大利新生儿学会、意大利儿科内分泌学和糖尿病学会以及意大利医学统计学和临床流行病学学会开展了一项多中心调查，旨在制作一份符合可靠新生儿图表应具备的一系列标准的意大利新生儿人体测量参考图表（意大利新生儿研究[INeS]图表）。在临床实践中，如果使用新生儿图表来监测早产新生儿从出生到足月的出生后生长情况，会存在一些局限性。为了克服与参考图表构建和使用相关的问题，一个国际项目最近启动了一项研究，旨在为早产儿出生后生长评估制定规范性标准（INTERGROWTH-21st）。虽然缺乏评估早产儿出生后生长的国际纵向标准，但在意大利，最佳折衷方案可能如下：足月前使用新的INeS图表；足月至2岁使用WHO 2006或CDC 2002国际纵向图表；最后，意大利儿科内分泌学和糖尿病学会（SIEDP）生长图表可能适合监测这些婴儿从2岁至20岁的生长情况。
