title: Monitoring postnatal growth of preterm infants: present and future.
abstract: BACKGROUND
  There is no consensus with regard to which charts are most suitable for monitoring the postnatal growth of preterm infants.
  
  
  OBJECTIVE
  We aimed to assess the strategies used to develop existing postnatal growth charts for preterm infants and their methodologic quality.
  
  
  METHODS
  A systematic review of observational longitudinal studies, having as their primary objective the creation of postnatal growth charts for preterm infants, was conducted. Thirty-eight items distributed in 3 methodologic domains ("study design," "statistical methods," and "reporting methods") were assessed in each study. Each item was scored as a "low" or "high" risk of bias. Two reviewers independently selected the studies, assessed the risk of bias, and extracted data. A total quality score [(number of "low risk" of bias marks/total number of items assessed) × 100%] was calculated for each study. Median (range, IQR) quality scores for each methodologic domain and for all included studies were computed.
  
  
  RESULTS
  Sixty-one studies met the inclusion criteria. Twenty-seven (44.3%) of the 61 studies scored ≥50%, of which 10 scored >60% and only 1 scored >66%. The median (range, IQR) quality score for the 61 included studies was 47% (26-75%, 34-56%). The scores for the domains study design, statistical methods, and reporting methods were 44% (19-67%, 33-52%), 25% (0-88%, 13-38%), and 33% (0-100%, 0-33%), respectively. The most common shortcomings were observed in items related to anthropometric measures (the main variable of interest), gestational age estimation, follow-up duration, reporting of postnatal care and morbidities, assessment of outliers, covariates, and chart presentation.
  
  
  CONCLUSIONS
  The overall methodologic quality of existing longitudinal studies was fair to low. To overcome these problems, the Preterm Postnatal Follow-up Study, 1 of the 3 main components of The International Fetal and Newborn Growth Consortium for the 21st Century Project, was designed to construct preterm postnatal growth standards from a prospective cohort of "healthy" pregnancies and preterm newborns without evidence of fetal growth restriction.
authors.affiliation: Department of Public Health and Pediatrics, University of Turin, Turin, Italy;
authors.forename: Francesca
authors.initials: F
authors.lastname: Giuliani
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom;
authors.forename: Leila
authors.initials: L
authors.lastname: Cheikh Ismail
authors.affiliation: Department of Public Health and Pediatrics, University of Turin, Turin, Italy;
authors.forename: Enrico
authors.initials: E
authors.lastname: Bertino
authors.affiliation: Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan; Center for Global Child Health, Hospital for Sick Children, Toronto, Canada;
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Centre for Statistics in Medicine, University of Oxford Botnar Research Centre, Oxford, United Kingdom;
authors.forename: Eric O
authors.initials: EO
authors.lastname: Ohuma
authors.affiliation: Department of Public Health and Pediatrics, University of Turin, Turin, Italy;
authors.forename: Ilaria
authors.initials: I
authors.lastname: Rovelli
authors.affiliation: Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; National Institutes of Health/Department of Health and Human Services, Detroit, MI.
authors.forename: Agustin
authors.initials: A
authors.lastname: Conde-Agudelo
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom;
authors.forename: José
authors.initials: J
authors.lastname: Villar
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom; stephen.kennedy@obs-gyn.ox.ac.uk.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Kennedy
mesh_terms: D002657:Child Development; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000517:prevention & control*; D057238:Growth Charts; D006130:Growth Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D057285:Precision Medicine; D011247:Pregnancy; D047928:Premature Birth / Q000178:diet therapy* / Q000503:physiopathology; D016216:Ultrasonography, Prenatal
keywords: growth charts; perinatal outcomes; phenotypes; postnatal growth; preterm birth; syndrome; systematic review