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

Abstract

Background: Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, was used in in the intensive care unit 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 the height at birth 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 are 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 two 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, and conducted in multiple centers should be considered to enroll a more representative Lebanese sample of children and be able to extrapolate our results to the national level.

Earlier Nutrient Fortification of Breastmilk Fed LBW Infants Improves Jaundice Related Outcomes

“…While for extremely low birth weight infants, Intergrowth 21st Project growth standards have been shown to be superior to Fenton Growth Charts [ 13 ], the picture for moderate to late term infants is not so clear. A recent study, where more than 50% of infants were between 34 and 36 weeks of gestation, showed that for the 2-week period immediately following birth, Fenton growth charts were superior to Intergrowth 21st [ 14 ]. Of particular concern is that Intergrowth-21st charts underestimate the rate of SGA compared to Fenton charts, which is of relevance in a lower socioeconomic community such as is the case with our study [ 15 ].…”

Differences When Classifying Small for Gestational Age Preterm Infants According to the Growth Chart Applied

“…To date, there are still few studies that have compared different population growth charts with Intergrowth-21st. 2,5,6,[17][18][19][20][21][22][23] However, its ability to identify the SGA infants remains under debate. 11 The aim of the present study is to compare Fenton, Olsen, and Intergrowth-21st growth charts, regarding the classification at birth and incidence of SGA in very preterm infants.…”