Implications for Quantifying Early Life Growth Trajectories of Term-born Infants Using INTERGROWTH-21st Newborn Size Standards at Birth in Conjunction with World Health Organization Child Growth Standards in the Postnatal Period

Overview

Journal Paediatr Perinat Epidemiol

Specialties Gynecology & Obstetrics
Pediatrics
Public Health

Date 2022 May 16

PMID 35570836

Authors

Nandita Perumal

Eric O Ohuma

Andrew M Prentice

Prakesh S Shah

Abdullah Al Mahmud

Sophie E Moore

Daniel E Roth

Affiliations

Soon will be listed here.

Abstract

Background: The INTERGROWTH-21st sex and gestational age (GA) specific newborn size standards (IG-NS) are intended to complement the World Health Organization Child Growth Standards (WHO-GS), which are not GA-specific. We examined the implications of using IG-NS at birth and WHO-GS at postnatal ages in longitudinal epidemiologic studies.

Objectives: The aim of this study was to quantify the extent to which standardised measures of newborn size and growth are affected when using WHO-GS versus IG-NS at birth among term-born infants.

Methods: Data from two prenatal trials in Bangladesh (n = 755) and The Gambia (n = 522) were used to estimate and compare size at birth and growth from birth to 3 months when using WHO-GS only ('WHO-GS') versus IG-NS at birth and WHO-GS postnatally ('IG-NS'). Mean length-for-age (LAZ), weight-for-age (WAZ) and head circumference-for-age (HCAZ), and the prevalence of undernutrition (stunting: LAZ < -2SD; underweight: WAZ < -2SD; and microcephaly: HCAZ < -2SD) were estimated overall and by GA strata [early-term (37 -38 ), full-term (39 -40 ) and late-term (41 -43 )]. We used Bland-Altman plots to compare continuous indices and Kappa statistic to compare categorical indicators.

Results: At birth, mean LAZ, WAZ and HCAZ, and the prevalence of undernutrition were most similar among newborns between 39 and 40 weeks of GA when using WHO-GS versus IG-NS. However, anthropometric indices were systematically lower among early-term infants and higher among late-term infants when using WHO-GS versus IG-NS. Early-term and late-term infants demonstrated relatively faster and slower growth, respectively, when using WHO-GS versus IG-NS, with the direction and magnitude of differences varying between anthropometric indices. Individual-level differences in attained size and growth, when using WHO-GS versus IG-NS, were greater than 0.2 SD in magnitude for >60% of infants across all anthropometric indices.

Conclusions: Using IG-NS at birth with WHO-GS postnatally is acceptable for full-term infants but may give a misleading interpretation of growth trajectories among early- and late-term infants.

Citing Articles

Implications for quantifying early life growth trajectories of term-born infants using INTERGROWTH-21st newborn size standards at birth in conjunction with World Health Organization child growth standards in the postnatal period.

Perumal N, Ohuma E, Prentice A, Shah P, Al Mahmud A, Moore S Paediatr Perinat Epidemiol. 2022; 36(6):839-850.

PMID: 35570836 PMC: 9790258. DOI: 10.1111/ppe.12880.

References

Yang S, Platt R, Kramer M . Variation in child cognitive ability by week of gestation among healthy term births. Am J Epidemiol. 2010; 171(4):399-406. PMC: 3435092. DOI: 10.1093/aje/kwp413. View

Heude B, Guern M, Forhan A, Scherdel P, Kadawathagedara M, Dufourg M . Are selection criteria for healthy pregnancies responsible for the gap between fetal growth in the French national Elfe birth cohort and the Intergrowth-21st fetal growth standards?. Paediatr Perinat Epidemiol. 2018; 33(1):47-56. DOI: 10.1111/ppe.12526. View

Eriksen K, Johnson W, Sonko B, Prentice A, Darboe M, Moore S . Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants. J Nutr. 2016; 147(2):248-255. PMC: 5265696. DOI: 10.3945/jn.116.241737. View

Perumal N, Roth D, Perdrizet J, Barros A, Santos I, Matijasevich A . Effect of correcting for gestational age at birth on population prevalence of early childhood undernutrition. Emerg Themes Epidemiol. 2018; 15:3. PMC: 5799899. DOI: 10.1186/s12982-018-0070-1. View

Liu S, Metcalfe A, Leon J, Sauve R, Kramer M, Joseph K . Evaluation of the INTERGROWTH-21st project newborn standard for use in Canada. PLoS One. 2017; 12(3):e0172910. PMC: 5336248. DOI: 10.1371/journal.pone.0172910. View

Revollo G, Martinez J, Grandi C, Alfaro E, Dipierri J . Prevalence of underweight and small for gestational age in Argentina: Comparison between the INTERGROWTH-21st standard and an Argentine reference. Arch Argent Pediatr. 2017; 115(6):547-555. DOI: 10.5546/aap.2017.eng.547. View

Altman D, Ohuma E . Statistical considerations for the development of prescriptive fetal and newborn growth standards in the INTERGROWTH-21st Project. BJOG. 2013; 120 Suppl 2:71-6, v. DOI: 10.1111/1471-0528.12031. View

de Onis M, Garza C, Victora C, Onyango A, Frongillo E, Martines J . The WHO Multicentre Growth Reference Study: planning, study design, and methodology. Food Nutr Bull. 2004; 25(1 Suppl):S15-26. DOI: 10.1177/15648265040251S103. View

Villar J, Papageorghiou A, Pang R, Ohuma E, Ismail L, Barros F . The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study. Lancet Diabetes Endocrinol. 2014; 2(10):781-92. DOI: 10.1016/S2213-8587(14)70121-4. View

10.

Moore S, Fulford A, Darboe M, Jobarteh M, Jarjou L, Prentice A . A randomized trial to investigate the effects of pre-natal and infant nutritional supplementation on infant immune development in rural Gambia: the ENID trial: Early Nutrition and Immune Development. BMC Pregnancy Childbirth. 2012; 12:107. PMC: 3534399. DOI: 10.1186/1471-2393-12-107. View

11.

Leung M, Perumal N, Mesfin E, Krishna A, Yang S, Johnson W . Metrics of early childhood growth in recent epidemiological research: A scoping review. PLoS One. 2018; 13(3):e0194565. PMC: 5860780. DOI: 10.1371/journal.pone.0194565. View

12.

Heimstad R, Romundstad P, Eik-Nes S, Salvesen K . Outcomes of pregnancy beyond 37 weeks of gestation. Obstet Gynecol. 2006; 108(3 Pt 1):500-8. DOI: 10.1097/01.AOG.0000227783.65800.0f. View

13.

Perumal N, Ohuma E, Prentice A, Shah P, Al Mahmud A, Moore S . Implications for quantifying early life growth trajectories of term-born infants using INTERGROWTH-21st newborn size standards at birth in conjunction with World Health Organization child growth standards in the postnatal period. Paediatr Perinat Epidemiol. 2022; 36(6):839-850. PMC: 9790258. DOI: 10.1111/ppe.12880. View

14.

Roth D, Gernand A, Morris S, Pezzack B, Islam M, Dimitris M . Maternal vitamin D supplementation during pregnancy and lactation to promote infant growth in Dhaka, Bangladesh (MDIG trial): study protocol for a randomized controlled trial. Trials. 2015; 16:300. PMC: 4499946. DOI: 10.1186/s13063-015-0825-8. View

15.

Roth D, Morris S, Zlotkin S, Gernand A, Ahmed T, Shanta S . Vitamin D Supplementation in Pregnancy and Lactation and Infant Growth. N Engl J Med. 2018; 379(6):535-546. PMC: 6004541. DOI: 10.1056/NEJMoa1800927. View

16.

Zhang X, Kramer M . Variations in mortality and morbidity by gestational age among infants born at term. J Pediatr. 2008; 154(3):358-62, 362.e1. DOI: 10.1016/j.jpeds.2008.09.013. View

17.

Anderson N, Sadler L, McKinlay C, McCowan L . INTERGROWTH-21st vs customized birthweight standards for identification of perinatal mortality and morbidity. Am J Obstet Gynecol. 2015; 214(4):509.e1-509.e7. DOI: 10.1016/j.ajog.2015.10.931. View

18.

Villar J, Giuliani F, Fenton T, Ohuma E, Ismail L, Kennedy S . INTERGROWTH-21st very preterm size at birth reference charts. Lancet. 2016; 387(10021):844-5. DOI: 10.1016/S0140-6736(16)00384-6. View

19.

Yang S, Fombonne E, Kramer M . Duration of gestation, size at birth and later childhood behaviour. Paediatr Perinat Epidemiol. 2011; 25(4):377-87. PMC: 3749844. DOI: 10.1111/j.1365-3016.2011.01193.x. View

20.

Villar J, Papageorghiou A, Pang R, Salomon L, Langer A, Victora C . Monitoring human growth and development: a continuum from the womb to the classroom. Am J Obstet Gynecol. 2015; 213(4):494-9. DOI: 10.1016/j.ajog.2015.07.002. View