Abstract
Objectives: To assess growth outcomes of VLBW infants using different growth References and to validate the practice of age adjustment for prematurity in the growth assessment for VLBW infants.
Methods: Longitudinal growth data of 514 VLBW infants from 4 to 36 months of adjusted age were analyzed separately based on chronological and adjusted age and by comparison with three growth References.
Results: More infants were labelled as having “subnormal growth” assessed on chronological age than on adjusted age throughout the first three years of life. The proportions of subnormal growth determined using a Canadian and the WHO reference for breastfed infants were similar; they were different from those obtained using the NCHS/WHO reference. Conclusions: Our findings suggested that the interpretations of growth in VLBW infants vary substantially depending on which reference is used. The age adjustment for prematurity makes substantial difference in identifying subnormal growth in VLBW infants. The adjustment should be carried out throughout the first three years of life.
Résumé
Objectifs: évaluer la croissance d’enfants de très petit poids de naissance en utilisant différentes courbes de croissance standards et valider la pratique qui consiste à corriger l’âge pour le degré de prématurité lors de l’évaluation de la croissance chez ces enfants.
Méthodes: Les données sur la croissance longitudinale de 514 enfants de très petit poids de naissance obtenues de 4 à 36 mois corrigés ont été analysées séparément en se basant sur l’âge chronologique et corrigé et par comparaison en utilisant trois différentes courbes de croissance standards.
Résultats: Durant les trois premières années de vie, plus d’enfants ont été étiquetés comme ayant “une croissance subnormale” lorsque l’on se basait sur l’âge chronologique que lorsqu’on se basait sur l’âge corrigé. La proportion d’enfants à croissance subnormale déterminée en utilisant des courbes de croissance canadienne et celle de l’OMS était la même pour les enfants allaités. Elle était toutefois différente de celle obtenue en utilisant les courbes de croissance SCNS/OMS.
Conclusions: Nos résultats suggèrent que la correction de l’âge pour le degré de prématurité crée une différence importante dans l’identification de la croissance subnormale parmi les enfants de très petit poids de naissance. Cette correction devrait être appliquée durant les trois premières années de vie. l’interprétation de la croissance des enfants de très petit poids de naissance varie de manière importante, dépendant de la courbe de croissance utilisée.
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