Gaining and Growing: Assuring Nutritional Care of Preterm Infants in the Community

Growth Charts for Preterm Infants

 Background
 Table of Available Charts
 Notes on using National Center for Health Statistics (CDC) Data for Assessment of Preterm Infants

Background

A number of growth charts have been developed for monitoring growth in this population. Charts demonstrating postnatal weight changes in the immediate postnatal period are often used in hospital. Several preterm growth charts have been developed for monitoring growth in this population after hospital discharge. In actual clinical practice in most communities, the CDC Growth charts that are commonly used to follow the growth of term infants and children are used for preterm infants as well. In this case the use of corrected ages is important.

Table of Available Charts

Growth Chart Name

Description

Gairdner-Pearson Growth and Development Record

(Gairdner & Pearson, 1971)
  • Separate charts for male/female
  • Compilation of growth data from several references
  • Built in correction for prematurity
  • Wt/Length/OFC
  • 24 wk GA-2 years
  • Available through: Castlemead Publications, 12 Little Mundells Welwyn, Garden City, Hertfordshire, AL7 1EW

Babson/Benda Intrauterine and Postnatal Growth Chart

(Babson, 1976)
  • Combined sexes
  • Built in correction for prematurity
  • Wt/length/OFC
  • 26 weeks- 12 mos CA
  • Available through Ross Laboratories

Fenton Growth Chart

(Fenton, 2003)
  • updated Babson/Benda
  • demonstrates similar pattern of growth as Babson/Benda
  • 22 weeks GA to 10 weeks post-term

IHDP Growth Percentiles

(IHDP,1990)
  • 4 separate charts VLBW male/female and LBW male/female
  • 2 months to 38 months
  • Wt/length/OFC
  • Available through Ross/Abbott laboratories

CDC Growth Charts

(National Center for Health Statistics 2000)
  • Wt, length or height, OFC, and wt/ln or BMI
  • Male and female charts
  • B-36 months and 2 years-18 months
  • *Note: in using these charts, correct for prematurity

Sherry et al evaluated postnatal growth charts for preterm infants based on curve design and external data set evaluation. Based on this evaluation, the IHDP chart met the greatest number of study design criteria. The IHDP more closely matched the external data set for length. The CDC chart more closely matched the external data set for weight. Sherry et al concluded that the choice of postnatal growth charts depends on the purpose of comparison. The IHDP chart offers a comparison with other preterm infants. The CDC allows for comparison to healthy full term infants. When using the CDC chart, growth should be corrected for prematurity. It is recommended that corrected age be used up to 2 years and for practicality may continue correcting to 36 months or when changing to use of the 2-18 year chart.

Notes on using CDC data for assessment of Preterm Infants

It is recommended that growth be plotted on CDC charts according to corrected age. Recommendations for how long to correct vary from 1-3 years of age. For practical purposes, when using the CDC charts, one might correct while using the infancy chart (birth to 36 months). When changing to 2-18 years may consider plotting uncorrected. Note that the impact of changing from correcting to not correcting involves a shift across growth channels and therefore will impact growth percentiles. It should not impact assessment of rates of growth. Correction is no longer necessary when the weeks or months of prematurity become a small fraction of the total age.

Nutrition Assessment: Growth Homepage
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More information contact: Joan Zerzan
Page reviewed: 3/20/2007