Fenton-13 vs. Intergrowth-21 Standards for the Assessment of Intrauterine and Postnatal Growth Restriction in Very Low Birth Weight Infants

Abstract

Objective: We aimed to compare the incidence of small for gestational age (SGA) and postnatal growth failure (PGF) of very low birth weight (VLBW) infants according to Fenton-13 and Intergrowth-21 curves. Methods: The records of babies with a birth weight of <1500 g were reviewed retrospectively. The percentile and z-scores for the babies' body weight and head circumference at birth and discharge were calculated using the web-based calculators developed by the Fenton-13 and Intergrowth-21 consortium. While SGA was defined as birth weight below the 10th percentile, body weight of <10th percentile for adjusted postmenstrual age at discharge was named as PGF. Infants who died, had major chromosomal/ congenital anomalies, and were diagnosed with perinatal asphyxia were excluded from the study. Results: Data of 651 babies with VLBW were analyzed. The incidence of SGA was found to be significantly higher according to Intergrowth-21 than Fenton-13 (9.8% vs 4.3%, p<0.001). However, the frequency of PGF was noted as similar in those charts (60.5-60.7%, p>0.05). However, body weight z-score/percentile and head circumference z score/percentile at discharge were significantly lower in Fenton-13 compared to Intergrowth-21 charts. Conclusion: In our study, while the incidence of SGA was higher based on the Intergrowth-21 charts, no difference was found between the two methods in terms of PGF. Accurate detection of intrauterine and postnatal growth restriction in VLBW infants enables the precise determination of the risk of short- and long-term adverse outcomes in this vulnerable population.

Keywords

• prematurity
• growth assessment
• fenton-13
• intergrowth-21
• postnatal growth failure