Abstract
Preterm infants are increasingly diagnosed as having “extrauterine growth restriction” (EUGR) or “postnatal growth failure” (PGF). Usually EUGR/PGF is diagnosed when weight is <10th percentile at either discharge or 36–40 weeks postmenstrual age. The reasons why the phrases EUGR/PGF are unhelpful include, they: (i) are not predictive of adverse outcome; (ii) are based only on weight without any consideration of head or length growth, proportionality, body composition, or genetic potential; (iii) ignore normal postnatal weight loss; (iv) are usually assessed prior to growth slowing of the reference fetus, around 36–40 weeks, and (v) are usually based on an arbitrary statistical growth percentile cut-off. Focus on EUGR/PGF prevalence may benefit with better attention to nutrition but may also harm with nutrition delivery above infants’ actual needs. In this paper, we highlight challenges associated with such arbitrary cut-offs and opportunities for further refinement of understanding growth and nutritional needs of preterm neonates.
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Acknowledgements
We thank Rhonda Clark and Jim Hawkins, the parents of 27-week twins, for their endorsement of these concepts.
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TRF conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. BC, DG, RN, BA, ME, WWH, AH, DA, FB, IG, NE, NR, ST, TS, RJS, SE, SG-W, DA, and PSS critically reviewed and revised the manuscript for important intellectual content All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Fenton, T.R., Cormack, B., Goldberg, D. et al. “Extrauterine growth restriction” and “postnatal growth failure” are misnomers for preterm infants. J Perinatol 40, 704–714 (2020). https://doi.org/10.1038/s41372-020-0658-5
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DOI: https://doi.org/10.1038/s41372-020-0658-5
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