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Hi colleagues,

In the past few years the assessment of growth in the newborn has been updated significantly. In the US, we use Fenton for preterm < 35weeks, CDC and WHO for late-preterm and term babies. I have . WHO for uses growth charts for 0-24 months and does not consider GA at birth, , so babies could easily be over-classified by SGA, or LGA if GA at birth is not used. For example: using medcal interactive growth charts (CDC-based); a newly born male at 37weeks who weight 2600grams is classify as AGA between 25th and 50th%tile. A baby with same BW, but with a GA at birth of 41 weeks (term) will be considered SGA (<10t%tile) with medcal. but AGA based on WHO; since they do not stratify babies by GA.

1- what is your current practice to classify preterm or term babies based on BW?

2- what growth charts are you using?

Thank you for any imput, references will be greatly appreciated

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It's a bit of a mess, and not very standardized in our practice and guidelines.

Birthweight for gestational age is often based on the Marsal growth curves (https://www.ncbi.nlm.nih.gov/pubmed/8819552) in our guidelines, but we also have the Fenton curves in Epic.
Growth after birth is often based on a mixture of WHO, whatever growth chart is available on paper in the department and now the new Danish reference curves (http://onlinelibrary.wiley.com/doi/10.1111/apa.12468/abstract).

To make things even better, depending on the department you are accessing Epic, the choice of growth curves differs...

I made a simple app for iOS with the Marsal growth curves (with the sparse text in Danish) - it's handy if you use the Marsal curves in your daily practice: https://itunes.apple.com/dk/app/gestationsalder/id1055021841?mt=8

 

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We plot BW on Fenton.  In our med-surg unit which has many older kids, our dietitians switch to WHO at some point (timing appears to be a bit idiosyncratic)

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We plot them on the Royal college of paediatrics and child health recommended growth charts. They are based on WHO (breastfed babies, UK population) and we have different ones for gestation ages and age groups. Trainees find it very useful, especially the NICM ones, as they can put weekly dates and avoids confusion about chronological vs corrected ages. It also provides other useful parameters and instructions on how to use it at the back. Very self explanatory.  

These are 

1. Neonatal and Infant Close Monitoring (NICM)

https://www.rcpch.ac.uk/system/files/protected/page/GIRLS NICM (4th Jan 2013).pdf

https://www.rcpch.ac.uk/system/files/protected/page/BOYS NICM (4th Jan 2013).pdf

2. 0-4 years 

https://www.rcpch.ac.uk/system/files/protected/page/A4 Boys 0-4YRS (4th Jan 2013).pdf

https://www.rcpch.ac.uk/system/files/protected/page/A4 Girls 0-4yrs WHO (4th Jan 2013).pdf

You can go to the website to get more info

https://www.rcpch.ac.uk/child-health/research-projects/uk-who-growth-charts/uk-who-growth-chart-resources-0-4-years/uk-who-0

Hope that helps

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