Neonatal Intensive Care Unit, Department of Neonatology, University General Hospital of Heraklion, 71500 Crete, Greece.
Clinic of Preventive Medicine and Nutrition, Division of Social Medicine, School of Medicine, University of Crete, 70013 Crete, Greece.
Nutrients. 2023 Jul 25;15(15):3290. doi: 10.3390/nu15153290.
Monitoring the growth of neonates in the Neonatal Intensive Care Unit (NICU) using growth charts constitutes an essential part of preterm infant care. Preterm infants are at increased risk for extrauterine growth restriction (EUGR) due to increased energy needs and clinical complications. This retrospective study compares the prevalence of small for gestational age (SGA) at birth and EUGR at discharge in extremely and very preterm neonates hospitalized in the NICU of a tertiary hospital in Greece, using different growth curves, and it examines the associated nutritional and clinical factors. Fenton2013 and INTERGROWTH-21st growth curves were used to calculate z-scores of birth weight (BW) and weight, length, and head circumference at discharge. The study includes 462 newborns with a mean BW of 1341.5 g and mean GA of 29.6 weeks. At birth, 6.3% of neonates were classified as SGA based on Fenton2013 curves compared to 9.3% with INTERGROWTH-21st growth curves. At discharge, 45.9% of neonates were characterized as having EUGR based on the Fenton2013 weight curves and 29.2% were characterized based οn INTERGROWTH-21st curves. Nutritional factors such as the day of initiation, attainment of full enteral feeding, and the duration of parenteral nutrition were associated with EUGR by both curves. The prevalence of SGA and EUGR neonates differs between the two growth references. This shows that further evaluation of these charts is needed to determine the most appropriate way to monitor infant growth.
使用生长图表监测新生儿重症监护病房（NICU）中的生长是早产儿护理的重要组成部分。由于能量需求增加和临床并发症，早产儿发生宫外生长受限（EUGR）的风险增加。本回顾性研究比较了在希腊一家三级医院的 NICU 住院的极早产儿和极早产儿出生时小胎龄儿（SGA）和出院时 EUGR 的患病率，使用了不同的生长曲线，并检查了相关的营养和临床因素。Fenton2013 和 INTERGROWTH-21st 生长曲线用于计算出生体重（BW）和体重、长度和头围的 z 评分。该研究包括 462 名新生儿，平均 BW 为 1341.5 g，GA 平均为 29.6 周。根据 Fenton2013 曲线，出生时 6.3%的新生儿被归类为 SGA，而根据 INTERGROWTH-21st 生长曲线，有 9.3%的新生儿被归类为 SGA。出院时，45.9%的新生儿根据 Fenton2013 体重曲线被归类为 EUGR，29.2%的新生儿根据 INTERGROWTH-21st 曲线被归类为 EUGR。营养因素，如开始喂养的天数、达到完全肠内喂养的天数和肠外营养的持续时间，与两种曲线的 EUGR 有关。两种生长参考标准之间 SGA 和 EUGR 新生儿的患病率不同。这表明需要进一步评估这些图表，以确定监测婴儿生长的最合适方法。
