Abstract
We made an analysis of several published curves concerning the human fetal and postnatal growth assessed by the three classical parameters including their velocity changes: the body weight, the length and the head circumference. The called fetal curves have a diagnostic purpose on the normality of growth during the fetal life. They derived from measurements go from 25 to 42 weeks. Among these diagnostic charts, the best from a mathematical and statistical points of views is the one of publishes by “Dombrowski”. Several other analyzed fetal curves may be criticized for not meeting all the criteria of a statistical normal population, mainly concerning the body weight. The called combined fetal and postnatal curves go from 25 to 60 weeks. They allow to make an appreciation of the normal of postnatal growth; they take into account the interruption of fetal life and the adaptation of growth for the priority of growth follows a different vector in this type of situations. Among these combined charts, the “Gairdner” and “Battisti” meet the criteria for all parameters. The analysis of velocity (their variability over time) of the different parameters of growth considered individually or as ratios between them has also been useful. The clinician having in care fragile neonates (those born before 30 weeks or below 1000g or those combining a prematurity and a fetal growth restriction) has an important task. It is to offer the best nutrition to them and to see if their growth is optimal as this can be important for the future. The clinician needs hence to plot longitudinally, on an appropriate curve , the three parameters of growth (body weight, length and head circumference). That should be done on a combined chart instead diagnostic curve. On the other hand, a reliable ratio emerged has a highly correlated index to optimal growth, and it can be used from 25 to 60 weeks of post-conceptional age (PCA) : d BW g/d HC cm = 44 PCA – 1138 (r = 0.973, p < 0.00001). By using that formula derived by two important and easy parameters (the body weight and the head circumference), on can appreciate the adequacy of growth whatever the considered moment in that period of life.
Highlights
Growth in general, and even more when it concerns a fragile neonate or child, is an important and constant aspect of care for the family and for the medical staff [1-9]
It aims to bring to the clinician pragmatic tools to appreciate the adequacy of nutrition and the longitudinal growth of the most fragile newborns: those born before 30 weeks, those having a body weight below 1000 g, those combining a prematurity and retarded intrauterine growth
The CV is given for each parameter: body weight (BW), length (BL) and head circumference (HC)
Summary
Even more when it concerns a fragile neonate or child, is an important and constant aspect of care for the family and for the medical staff [1-9]. There are the relative indices such as the ponderal index, the body mass or Quetelet’s index: they are the ratios among different parameters These indices have the purpose to assess the harmony of growth. It aims to bring to the clinician pragmatic tools to appreciate the adequacy of nutrition and the longitudinal growth of the most fragile newborns: those born before 30 weeks, those having a body weight below 1000 g, those combining a prematurity and retarded intrauterine growth. For these situations are being questionable at least during the hospital period till 60 weeks post conceptional age or PCA [12-37]. Concerning these populations, the simple questions « which curve, what parameters of growth should be chosen?» may become complex (35b)
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