Is the Intrauterine INTERGROWTH-21 Growth Curve Better Than Fenton’s for the Classification at Birth and Prediction of Postnatal Growth in Preterm Infants?

Lebrão, Cibele Wolf; Souza, Fabíola Isabel Suano de; Sarni, Roseli Oselka Saccardo

doi:10.1007/s10995-020-02988-2

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…On the contrary, in another study, Reddy et al pointed out that neonates classified as SGA at birth by INTERGROWTH-21st and not by Fenton2013 growth charts had a higher incidence of morbidities such as sepsis and ROP [41]. In other studies, no significant difference was observed for the classification of birth weight for GA in preterm neonates born before 33 weeks between the two assessment growth charts [42,43]. It is very essential to accurately define SGA with appropriate charts, since being born SGA is associated with an increased risk of higher mortality, postnatal growth failure, and neurodevelopmental impairment at 18-22 months of corrected age [44].…”

Section: Discussionmentioning

confidence: 89%

The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors

Kakatsaki,

Papanikolaou,

Roumeliotaki

et al. 2023

Nutrients

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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.

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Section: Discussionmentioning

confidence: 89%

The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors

Kakatsaki,

Papanikolaou,

Roumeliotaki

et al. 2023

Nutrients

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“…Lebrao et al ( 23 ) in a retrospective study with 26–33 weeks preterms ( n = 173) showed that IW-21 and Fenton were similar for classifying IUGR by weight (35.2 vs. 39.2%). In Barreto's series, which included 2,489 newborns between 34 and 41 weeks, fewer patients were only identified as IUGR using IW-21 (13 vs. 8.7%) ( 21 ).…”

Section: Discussionmentioning

confidence: 98%

Extrauterine Growth Restriction in Very Low Birth Weight Infants: Concordance Between Fenton 2013 and INTERGROWTH-21st Growth Charts

et al. 2021

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Postnatal growth restriction has high prevalence in very low birth weight (VLBW) preterm neonates, and this could affect their long-term prognosis. Nowadays, there is no consensus on how to monitor growth in these neonates.Objective: This study aimed to compare prevalence of intra- and extrauterine growth restriction (IUGR and EUGR) in a sample of VLBW infants according to the Fenton 2013 charts and INTERGROWTH-21st (IW-21) standards and to analyze concordance between both in the different EUGR definitions criteria (cross-sectional, dynamic, and true).Patients and Methods: An observational retrospective study of 635 VLBW preterm was performed. The study was carried out in Central University Hospital of Asturias. Body measurements (weight, length, and head circumference) were collected at birth and at hospital discharge and expressed in z-scores for the two references (Fenton 2010 and IW-21). Kappa concordance was calculated.Results: Kappa concordance between Fenton and IW-21 was 0.887 for IUGR and 0.580 for static EUGR. Prevalence was higher according to Fenton in IUGR (36.5 vs. 35.1%), in static EUGR (73.8 vs. 59.3%), and in dynamic EUGR (44.3 vs. 29.3%). Despite observing low prevalence of EUGR when IW-21 was used to define EUGR, a statistical association between neonatal morbidity and diagnosis of EUGR was observed.Conclusion: The Fenton and IW-21 concordance for IUGR is good. IW-21 is more restrictive than Fenton in EUGR. Patients diagnosed by IW-21 as EUGR are more likely to have neonatal morbidity, especially if we use EUGR dynamic definition. In our study, we cannot conclude that one graph is better than the other.

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“…This shows that preterm growth centiles of Fenton 2013 and IG-21 seem to have good concordance with each other. A retrospective study published in 2020 by Lebrao et al [ 19 ] in Brazil among 173 preterm neonates (birth weight of less than 1500 grams and gestational age between 26 to 33 weeks) suggested that Fenton 2013 and IG-21 were similar in terms of classification of birth weight for preterm neonates. They observed a similar incidence of SGA (35.2% in Fenton vs. 39.2 in IG-21) with Cramer’s test V score of 0.533, indicating very strong agreement.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Study Comparing the Efficacy of Various Growth Charts in Evaluating the Incidences of Small for Gestational Age and Large for Gestational Age at Birth Among Liveborn Neonates Delivered at a Tertiary Teaching Hospital

Singamala¹,

Subramanian²,

Chitgupikar³

2023

Cureus

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Background and objective Growth charts are important in monitoring the growth of neonates. The growth of Indian fetuses is understood to be different from the Western population due to multiple factors. In this study, we aimed to analyze the utility of the application of various growth charts in evaluating the birth weights of liveborn neonates at a tertiary teaching hospital. Methodology A total of 729 liveborn neonates between 24 to 42 weeks of gestation delivered at the study institute during the study period were included. Birth weights were plotted on three growth charts - Fenton 2013, INTERGROWTH-21st (IG-21), and Kandraju et al. chart - and classified as small for gestational age (SGA), or appropriate for gestational age (AGA), or large for gestational age (LGA) according to the respective centiles and sex. The incidences of SGA and LGA were calculated with respect to various charts and compared. Statistical analysis was done using the McNemar Chi-square test for paired categorical variables. Cohen’s kappa (K) was used to analyze the concordance between the growth charts. A p-value <0.005 was considered statistically significant. Results Among 668 term neonates, the number of neonates classified as SGA was 313 (46.86%), 236 (35.33%), and 219 (32.78%) according to Fenton 2013, IG-21, and Kandraju et al. chart respectively. The difference in incidences of SGA between Fenton 2013 and IG-21 for term neonates was significant (p=0.0001). The difference between incidences of SGA among term neonates according to Fenton 2013 and Kandraju et al. and IG-21 vs. Kandraju et al. was significant (p=0.0001). Among 61 preterm neonates, the number of neonates classified as SGA was 15, 11, and five according to Fenton 2013, IG-21, and Kandraju et al. respectively. There was no statistically significant difference between the three charts. Among 729 neonates, the number of neonates classified as LGA was 10 (1.37%), 22 (3.02%), and 32 (4.39%) according to Fenton 2013, IG-21, and Kandraju, et al. respectively. The difference in incidences of LGA between Fenton 2013 and IG-21 was significant (p=0.0015). The difference in incidences of LGA between Fenton 2013 and Kandraju et al. was significant (p=0.0001). The difference in incidences of LGA between IG-21 and Kandraju et al. was also significant (p=0.0044). Conclusion Fenton 2013, IG-21, and Kandraju et al. growth charts vary significantly in detecting the incidence of SGA and LGA among term neonates. Among term neonates, IG-21 and Kandraju et al. growth charts are comparable in terms of the estimation of SGA. The Fenton 2013 growth chart showed a higher incidence of SGA among term neonates. The incidence of LGA was highest according to Kandraju et al. growth chart and least according to Fenton 2013. Among preterm neonates, the incidence of SGA as per birth weight was comparable across the three growth charts.

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Is the Intrauterine INTERGROWTH-21 Growth Curve Better Than Fenton’s for the Classification at Birth and Prediction of Postnatal Growth in Preterm Infants?

Cited by 11 publications

References 23 publications

The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors

The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors

Extrauterine Growth Restriction in Very Low Birth Weight Infants: Concordance Between Fenton 2013 and INTERGROWTH-21st Growth Charts

A Cross-Sectional Study Comparing the Efficacy of Various Growth Charts in Evaluating the Incidences of Small for Gestational Age and Large for Gestational Age at Birth Among Liveborn Neonates Delivered at a Tertiary Teaching Hospital

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