Newborn Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK,
Newborn Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Neonatology. 2020;117(3):300-307. doi: 10.1159/000507024. Epub 2020 May 12.
Current practice in the UK is to plot premature infant anthropometric measurements on Neonatal and Infant Close Monitoring (NICM) reference charts. These charts have several known limitations. The INTERGROWTH-21st Project has recently produced international ante- and postnatal growth standards. Exact knowledge of growth centiles allows clinicians to accurately assess infant nutritional requirements.
To compare target centile measurements between INTERGROWTH-21st and UK NICM growth charts for premature infants.
Anthropometric measurements (weight and head circumference) of a convenience sample of neonates born between 24 and 32 weeks of gestation were analysed retrospectively. Measurements were collected across three time points and plotted on both the NICM and INTERGROWTH-21st growth charts. The respective centiles were compared and analysed by paired-sample t test, Wilcoxon rank test analysis, and multilevel mixed-effect linear regression models.
Centiles for weight and head circumference measurements of 96 infants plotted on INTERGROWTH-21st charts were significantly greater than their corresponding UK charts at all three time points. For weight, the average difference between the two charts varied from 9.1 to 16.4 centiles. The difference between the two charts was greater for female than male infants by up to 6.9 centiles (95% CI 10.1-3.8).
Existing UK NICM reference charts are significantly different to the growth standards of INTERGROWTH-21st. The choice of which growth chart to adopt in the UK could have important consequences on premature infants' future adult health and therefore requires further prospective observational studies with larger data sets including length measurements and more comprehensive population characteristics.
目前英国的做法是将早产儿的人体测量值绘制在新生儿和婴儿密切监测（NICM）参考图表上。这些图表有几个已知的局限性。最近，INTERGROWTH-21 项目制定了国际产前和产后生长标准。准确了解生长百分位数可以使临床医生准确评估婴儿的营养需求。
比较 INTERGROWTH-21 与英国 NICM 生长图表之间早产儿目标百分位数测量值。
回顾性分析了在 24 至 32 周胎龄之间出生的新生儿的便利样本的人体测量值（体重和头围）。在三个时间点收集测量值，并绘制在 NICM 和 INTERGROWTH-21 生长图表上。通过配对样本 t 检验、Wilcoxon 秩检验分析和多层次混合效应线性回归模型比较和分析相应的百分位数。
96 名婴儿的体重和头围测量值绘制在 INTERGROWTH-21 图表上的百分位数在所有三个时间点均显著大于其相应的英国图表。对于体重，两个图表之间的平均差异从 9.1 到 16.4 个百分位不等。与男性婴儿相比，女性婴儿的两个图表之间的差异高达 6.9 个百分位（95%CI 10.1-3.8）。
现有的英国 NICM 参考图表与 INTERGROWTH-21 的生长标准有显著差异。英国采用哪种生长图表可能对早产儿未来的成人健康产生重要影响，因此需要进一步进行前瞻性观察研究，使用更大的数据集包括长度测量值和更全面的人群特征。
