Most of us are familiar with plotting an infant's growth against a growth curve. But WHAT is the norm? And what about growth during fetal development?
In response to this question, a global team led by Oxford University scientists has developed the INTERGROWTH-21 st Project Postnatal Growth Standards (PPGS). This project has created globally validated growth standards for babies based on a study of approximately 60,000 health women from urban areas in eight countries - Brazil, China, India, Italy, Kenya, Oman, the UK, and USA. These standards provide 3rd, 10th, 50th, 90th, and 97th percentile curves for a baby’s growth during pregnancy and for a baby’s size at birth according to gestational age
These new standards improved upon the ones before them in the sense that they now provide a standard for how babies should grown under normal conditions. Previously, physicians would compare a newborn’s weight and length against growth charts made from data on previous births in the country they live in, but that method only really works if the population of that country is completely healthy. In other words, if babies born before were unhealthy and the country’s standards are based on a chronically undernourished sample, then newborns are continuously being held to standards based on characteristics of poor health.
The INTERGROWTH-21 st Project addresses this problem by sampling a large pool of healthy women from various countries in order to develop true norms for fetal growth and newborn size that can be used in any country.
The hope is that these improved guidelines will help doctors identify poor growth in the womb early enough to intervene effectively. Low birth weight is associated with many health problems such as illness and death in infancy and childhood and increased risk of diabetes, high blood pressure, and cardiovascular disease in adulthood. On the other side of the spectrum, being overweight at birth can, too, lead to increased risk to certain diseases later in life and additional burden on the healthcare system.
In November 2016, the INTERGROWTH-21 st team announced its collaboration with the Swiss-based Family Larsson-Rosenquist Foundation. The team hopes that the partnership will help to establish evidence-based feeding and monitoring practices and PPGS for preterm infants, implement feeding protocol and PPGS into selected, influential neonatal units around the world, and to gain high-level health policy support for implementing the feeding protocol and PPGS.
Blog by Vivian Shih
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