The Babson and Benda growth chart for preterm babies is usually used when it comes to newborn intensive care. The main purpose of this study was to make a premature growth chart that begins at 22 weeks. The growth chart is supposed to be based on a meta-analysis of already published studies that were used as references.
Monitoring growth is a common practice when it comes to preterm babies. It is a part of the nutritional and medical assessment of babies born preterm. The basis for this assessment is provided with a premature growth chart. This is achieved because a reference comparison is provided and that allows a visual picture of growth trajectory and infant’s achieved size.
Parents are usually concerned whether a preterm baby can grow properly and maintain growth velocity compared to regularly born children. Growth chart for preterm babies allows this comparison. The new Babson and Benda chart extended the pre-birth chart by including more information based on regularly born infants and their growth. The char is published in 1976 and is generally referred to as “fetal-infant growth graph”.
A recent survey of about 120 infant health professionals shows that the most frequently used growth chart is that of Babson. Another growth chart for preterm babies frequently used is that of Lubchenco, Hansman, and Boyd.
However, Babson growth chart also has its limitations. The beginning of the X-axis is at 26 weeks which limits the usefulness of the chart for younger preterm babies. Also, the Y-axis is compiled of 500-gram increments which are also making the procedure a bit harder.
Researchers were using the literature for more than 20 years (1980-2002) to collect more recent data to complete the post and preterm sections of the chart. Population studies with large sample sizes were a great spot for finding the data researchers needed. Then, the researchers were comparing the Babson and Benda graph to the new chart.
The growth results from the Institute of Child Health and Human Developmental Neonatal Research Network were superimposed on the new chart to validate it.
It was needed to use two types of data to improve the Babson graph: regularly born infants’ measurements for the post-term section, and the size of an infant at birth for the pre-birth section. As already mentioned, to improve generalizability the researchers used large sample size population studies. It was recommended by the World Health Organization that completed weeks should be used to describe the gestational age of infants. The researches were using the data stated in this manner because of that. Also, to ensure accuracy, the researchers were preferring numerical data over graphic depiction.
The new premature growth chart gave very similar results to the old one in terms of curves and patterns. The big differences between the two chart’s curves had statistical significance after the term. The 10th percentiles of Babson’s fell between the percentiles of the new data: the 6th and 16th for length, the 5th and 15th for head circumference, and the 5the to 17 for weight.
As already mentioned, the researchers used the growth patterns of the NICHD infants. These patterns were different from the curves of the chart in the first few weeks of life. The infants with the birth weight of 1.5 pounds to 2.2 pounds were greater than the 10th percentile when it comes to head growth. This was concluded once the infants reached about 4.5 pounds. However, they remained below the 3rd percentile for length and weight.
The average head size was still below the 10th percentile only for the smallest group. Only the largest group’s growth length had an average size above the 3rd percentile, same as with weight.
The growth charts we use will only be as accurate as of the measurements made of the babies. The measurements done by using paper tapes for head circumference and electronic scales for weight are reliable. On the other hand, length measurements may appear inadequate or excessive or even may be undetected. This is proven even under controlled conditions. Babies are supposed to be measured by two people on a headboard to improve length data accuracy.
The bad thing about the research is that the literature of the data sources based on the population has no description of the tapes and scales used for measuring the babies. Also, there’s no accuracy described that validates the instruments used for the measurement. It is believed that different results occurred since the data sources were population-based.
It is important to monitor the head growth. This is mainly because the deviating growth from the intrauterine rate will possibly indicate some problems. Growth velocity calculation over several days is recommended because it shows a precise growth measure.
The updated growth chart supports monitoring the growth of preterm babies from 10 weeks after birth up to 22 weeks of gestational age. The chart allows a comparison of the regularly born infants and the fetus with an infant’s growth. This allows an evaluation of catch up growth.
The “fetal-infant growth graph” had well accurate estimates in the 50th percentile. However, due to the more accurate age assignments and large sample sizes, we’re provided with better confidence even in the extremes.
You have to know that this growth chart is validated by the data sources quality and the results’ heterogeneity. This goes for meta-analysis and every growth chart is affected by the same things.
Baby Planet Overview
We can take a better look at how our preterm babies will grow through life with the new preterm growth chart. The new chart is based on the Babson and Brenda growth chart and used the available data resources for completion. It is more accurate than the one we used before and therefore more reliable.
Consult with your pediatrician if you’re not able to understand the new growth chart properly.
- A new growth chart for preterm babies, bmcpediatr.biomedcentral.com