This Article Full Text Full Text (PDF) An erratum has been published Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Sherry, B. Articles by Dietz, W. H. Search for Related Content PubMed PubMed Citation Articles by Sherry, B. Articles by Dietz, W. H. Related Collections Premature & Newborn

PEDIATRICS Vol. 111 No. 4 April 2003, pp. 750-758

Evaluation of and Recommendations for Growth References for Very Low Birth Weight (1500 Grams) Infants in the United States

Bettylou Sherry, PhD, RD, Zuguo Mei, MD, MPH, Laurence Grummer-Strawn, PhD and William H. Dietz, MD, PhD

From the Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

--> Objective. To determine the best available growth reference for evaluating the growth status of very low birth weight (VLBW; 1500 g) infants in the United States.

Methods. We evaluated currently available growth references for VLBW infants in studies by Casey (Infant Health and Development Program [IHDP]), Brandt, Gairdner and Pearson, and Babson and Benda. We selected the 1 that best met a priori criteria and compared it with the new Centers for Disease Control and Prevention (CDC) growth charts. We evaluated the performance of both the selected VLBW reference and the CDC growth charts for use with VLBW infants by plotting data from 2 external data sets of VLBW infants (from Child Health and Development Studies [CHDS]) and linked the CDC’s Pregnancy Nutrition Surveillance System/Pediatric Nutrition Surveillance System Data (PNSS/PedNSS) on both references. Age was adjusted for gestational age in all of the VLBW data set comparisons.

Results. The IHDP reference met the greatest number of our evaluation criteria. The IHDP charts are the most recent, are based on a relatively large sample of VLBW infants in the United States, and are adjusted for gestational age at birth (using the standard of birth at 40 weeks) to account for prematurity. The IHDP VLBW infants, based on corrected postnatal age, compared with the non-VLBW infants included in the new CDC growth charts showed more rapid growth in length-for-age from birth (40 weeks) to 24 months, were nearly equivalent in weight-for-age at birth (40 weeks), yet demonstrated less rapid growth in weight-for-age from 40 weeks to 24 months. The performance evaluation of the IHDP and CDC growth reference based on the 2 external VLBW data sets (CHDS and PNSS/PedNSS) showed that the IHDP charts more closely matched the external data sets in relative position on the graphs and growth patterns for length-for-age, but the CDC growth charts more closely matched the external data sets in the growth pattern for weight-for-length. In weight-for-age, because of the lack of stability in the pattern, we could not determine which reference the external data growth pattern more closely matched.

Conclusions. Our evaluation of growth references for VLBW infants yielded no clear, simple recommendation. The inconsistencies in the discrepancies across anthropometric indices between the 2 external combined VLBW data sets (CHDS and PNSS/PedNSS) and the IHDP reference and the CDC growth charts make it difficult to recommend 1 reference. Therefore, we recommend using either the IHDP reference or the CDC growth charts to evaluate the growth of VLBW infants. The choice of which to use depends on its purpose. The IHDP reference is the best available reference for comparisons of the growth of a VLBW infant with those of other VLBW infants. The CDC growth charts allow comparison of the growth of a VLBW infant with that of non-VLBW infants.

Key Words: very low birth weight infants • growth references • growth status • performance evaluation

Abbreviations: VLBW, very low birth weight • IUGR, intrauterine growth retardation • CDC, Centers for Disease Control and Prevention • LBW, low birth weight • IHDP, Infant Health and Development Program • CHDS, Child Health and Development Studies • PNSS/PedNSS, Pregnancy • Nutrition Surveillance System/Pediatric Nutrition Surveillance System

---

Received for publication Jan 18, 2002; Accepted Sep 16, 2002.

This article has been cited by other articles:

				A. Nash, D. Secker, M. Corey, M. Dunn, and D. L. O'Connor Field Testing of the 2006 World Health Organization Growth Charts From Birth to 2 Years: Assessment of Hospital Undernutrition and Overnutrition Rates and the Usefulness of BMI JPEN J Parenter Enteral Nutr, March 1, 2008; 32(2): 145 - 153. [Abstract] [Full Text] [PDF]

				D. R. O'Leary, S. Kuhn, K. L. Kniss, A. F. Hinckley, S. A. Rasmussen, W. J. Pape, L. K. Kightlinger, B. D. Beecham, T. K. Miller, D. F. Neitzel, et al. Birth Outcomes Following West Nile Virus Infection of Pregnant Women in the United States: 2003-2004 Pediatrics, March 1, 2006; 117(3): e537 - e545. [Abstract] [Full Text] [PDF]

				American Society for Parenteral and Enteral Nutrit, and Task Force on Standards for Specialized Nutrit, Jane Balint, Catherine Crill, and Kimberly Klotz Standards for Specialized Nutrition Support: Hospitalized Pediatric Patients Nutr Clin Pract, February 1, 2005; 20(1): 103 - 116. [Full Text] [PDF]