Neonatal growth charts

The ability to recognize abnormal growth at birth and/or an intrauterine malnutrition is of great importance for neonatal care and prognosis. The current gold standard in neonatal auxological evaluation is based on information obtained from both neonatal anthropometric charts and intrauterine growth charts. Numerous charts have been proposed, but they are hardly comparable with each other, due to numerous methodological problems. The Italian Society of Neonatology, the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Medical Statistics and Clinical Epidemiology promoted a multicenter survey with the aim to produce an Italian neonatal anthropometric reference (Italian Neonatal Study [INeS] charts) fulfilling the set of the criteria that a reliable neonatal chart should possess. In clinical practice neonatal charts have some limitations if they are used to monitor postnatal growth of preterm newborns from birth to term. To overcome the problems related to the construction and use of a reference, an international project has recently started a study aiming to create prescriptive standard for the evaluation of postnatal growth of preterm infants (INTERGROWTH-21st). While an international longitudinal standard for evaluating preterm infant postnatal growth is lacking, in Italy the best compromise is likely to be as follows: new INeS charts up to term; International longitudinal charts WHO 2006 or CDC 2002 from term to 2 years; finally, the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP) growth charts could be suitable for monitoring the growth of these infants from 2 years up to 20 years of age.