Objective To use repeated measurements of weight, length and head circumference to generate growth centile charts reflecting real-world growth of a population of very preterm infants with a well-described nutritional intake close to current recommendations.
Design Infants born before 30 weeks gestational age (GA) were recruited. Infants received nutrition according to an integrated care pathway, with nutrient intake recorded daily, weight recorded twice-weekly and length and head circumference weekly. The LMS method was used to construct growth centile charts between 24 and 36 weeks corrected GA for each parameter.
Setting A single tertiary neonatal unit in England.
Patients 212 infants (124 male) (median GA at birth: 27.3 weeks, median birth weight: 900 g).
Results Median daily energy, protein, carbohydrate and fat intake were within 3% of published recommendations. The total number of measurements recorded was 5944 (3431 for weight, 1227 for length and 1286 for head circumference). Centile charts were formed for each parameter. Data for male and female infants demonstrated similar patterns of growth and were pooled for LMS analysis. A web application was created and published (bit.ly/sotongrowth) to allow infants to be plotted on these charts with changes in SD score of measurements reported and graphically illustrated.
Conclusions These charts reflect growth in a real-world cohort of preterm infants whose nutrient intakes are close to current recommendations. This work demonstrates the feasibility of forming growth charts from serial measurements of growing preterm infants fed according to current recommendations which will aid clinicians in setting a benchmark for achievable early growth.
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Contributors AY made a substantial contribution to the design of the work and to the analysis and interpretation of the data for the work. He drafted the work and created the web application. ETA and JJA made substantial contributions to the conception of the work and to the acquisition of data for the work. They revised the work critically for important intellectual content. FP and RMB made a substantial contribution to the conception and design of the work. They revised the work critically for important intellectual content. MJJ made a substantial contribution to the conception and design of the work and to the interpretation of data for the work. He revised the work critically for important intellectual content.
Funding AY, MJJ and RMB are supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. JJA is funded by an Action Medical Research training fellowship and by an ESPEN personal fellowship.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval NHS Research Ethics Committee (Oxford A, ref 14/SC/1275).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. We will share individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures and appendices), along with the study protocol and analytical code to researchers who provide a methodologically sound proposal beginning 3 months and ending 5 years following article publication. Proposals should be directed to AY (firstname.lastname@example.org).
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