Comparative study between Fenton and intergrowth 21 charts in a sample of Lebanese premature babies.

BACKGROUND

Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, has been used in the neonates' intensive care unit (NICU) of the Notre Dame des Secours University Hospital to assess premature newborns' development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit.

METHODS

We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentiles was filled on both charts from birth till 1 month of age.

RESULTS

The results of the linear regression, taking the weight at birth as the dependent variable, showed that the Fenton scale (R2 = 0.391) would predict the weight at birth better than the Intergrowth 21 scale (R2 = 0.257). The same applies for height and cranial perimeter at birth when taken as dependent variables. When considering the weight and height at 2 weeks, the results showed that the Intergrowth 21 scale would predict those variables better than the Fenton scale, with higher R2 values higher in favor of the Intergrowth 21 scale for both weight (0.384 vs 0.311) and height (0.650 vs 0.585). At 4 weeks, the results showed that the Fenton scale would predict weight (R2 = 0.655 vs 0.631) and height (R2 = 0.710 vs 0.643) better than the Intergrowth 21 scale. The results obtained were adjusted over the newborns' sociodemographic and clinical factors.

CONCLUSION

The results of our study are controversial where the Fenton growth charts are superior to Intergrowth 21 before 2 weeks of age and at 4 weeks, whereas Intergrowth 21 charts showed higher percentiles for weight and height than Fenton charts at 2 two weeks of age. Further studies following a different design, such as a clinical trial or a prospective study, taking multiple ethnicities into account and conducted in multiple centers should be considered to enroll a more representative sample of Lebanese children and be able to extrapolate our results to the national level.