Fenton Tanis R, Elmrayed Seham, Alshaikh Belal N
Community Health Sciences, Alberta Children's Hospital Research Institute, O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Institute of Global Health and Human Ecology, American University in Cairo, New Cairo, Egypt.
Paediatr Perinat Epidemiol. 2025 Jun 19. doi: 10.1111/ppe.70035.
Experts recommend assessing preterm infant growth against fetal growth patterns. However, obtaining accurate estimates of healthy fetal growth from preterm infants is challenging as many had intrauterine faltering growth.
To improve preterm infant growth assessments by developing Fenton third-generation sex-specific preterm growth charts based on anthropometric distributions of preterm infants without abnormal fetal growth. We also aimed to evaluate the consistency of the new charts' growth velocities.
From the last search for the 2013 Fenton growth charts to November 2024, MEDLINE and EMBASE databases, grey literature, as well as US Vital statistics and iNeo Consortium.
We followed systematic review methodology to identify population-based sex-specific anthropometric estimates of preterm cohorts without abnormal fetal growth beginning ≤ 24 weeks of gestation. Specified a priori, outcomes included newborn sex-specific estimates of birthweight, length, and head circumference.
We followed PRISMA guidelines. Literature screening and quality assessment were performed in duplicate. We harmonised weight, length, and head circumference weighted-average meta-analyses with the World Health Organization growth standard and rescaled the charts' x-axis from completed gestational weeks to exact gestational age (weeks and days).
Seven studies from 15 countries (Australia, Brazil, Canada, China, Finland, Israel, Italy, Japan, Netherlands, New Zealand, Sweden, Switzerland, Spain, United Kingdom and United States) were included, representing 4.8 million births 22-42 weeks of gestation. 174,184 were < 30 weeks gestational age. The Fenton third-generation preterm growth charts' weights showed improved growth velocity across percentiles with consistent declines for weight, length and head circumference velocity as post-menstrual age increased. The birthweight meta-analysis curves had similar shapes to fetal ultrasound estimates.
The Fenton third-generation preterm infant growth chart curves demonstrate improved and more uniform slopes across percentiles and closer alignment with fetal ultrasound estimates, offering a growth standard for preterm infants.
CRD42024589756.
专家建议根据胎儿生长模式评估早产儿生长情况。然而，由于许多早产儿存在宫内生长迟缓，从他们身上获得健康胎儿生长的准确估计具有挑战性。
通过基于无异常胎儿生长的早产儿人体测量分布制定芬顿第三代特定性别的早产儿生长图表，以改善早产儿生长评估。我们还旨在评估新图表生长速度的一致性。
从上次检索2013年芬顿生长图表至2024年11月，检索了MEDLINE和EMBASE数据库、灰色文献以及美国生命统计数据和iNeo联盟。
我们遵循系统评价方法，以识别妊娠≤24周开始的无异常胎儿生长的基于人群的特定性别的早产儿队列人体测量估计值。预先指定的结果包括按新生儿性别估计的出生体重、身长和头围。
我们遵循PRISMA指南。文献筛选和质量评估由两人独立进行。我们将体重、身长和头围加权平均荟萃分析与世界卫生组织生长标准进行了协调，并将图表的x轴从完成孕周重新标度为精确孕周（周和天）。
纳入了来自15个国家（澳大利亚、巴西、加拿大、中国、芬兰、以色列、意大利、日本、荷兰、新西兰、瑞典、瑞士、西班牙、英国和美国）的7项研究，代表了妊娠22 - 42周的480万例出生。174,184例为孕周<30周。芬顿第三代早产儿生长图表的体重在各百分位数上显示出改善的生长速度，随着月经后年龄增加，体重、身长和头围速度持续下降。出生体重荟萃分析曲线的形状与胎儿超声估计值相似。
芬顿第三代早产儿生长图表曲线在各百分位数上显示出改善且更均匀的斜率，并且与胎儿超声估计值更接近，为早产儿提供了一个生长标准。
PROSPERO注册编号：CRD42024589756。
