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How should we chart the growth of very preterm babies?
  1. Freya Pearson1,
  2. Mark John Johnson1,2
  1. 1Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
  1. Correspondence to Dr Freya Pearson, Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; freya.pearson{at}uhs.nhs.uk

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Advances in neonatal intensive care have resulted in an increase in survival of babies born at the extremes of viability, and consequently there has been, in recent years, more of a focus on the reduction of the burden of morbidity. A large body of research has centred on providing optimum nutrition for these vulnerable infants to improve outcomes, and central to this is the assessment of growth using published standardised growth charts.

History of growth charts

Growth charts used by those caring for infants and children have been developed and refined over decades to try and provide accurate centile curves for assessment of growth in terms of weight gain, length/height and head circumference. Large longitudinal cohort studies of healthy babies and children are the gold standard for producing reference data. The biggest and most recent study of term infants, the WHO Multicentre Growth Reference Study (MGRS), was undertaken between 1997 and 2003 to generate new growth curves for assessing the growth and development of infants and young children. It collected longitudinal data on 8500 children from five different countries with differing ethnic and cultural settings around the world from birth to 5 years. The growth curves published in 2006 provided a single international standard based on a healthy breastfed infant as the ‘normative model for growth and development’.

In the UK, data from the WHO study were used to replace existing data for term infants from 2 weeks of age. However, there has been little change in the centile chart for preterm infants as they could not be included in this study. Instead, the original 1990 growth data used to construct the …

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