They published this chart in 1976 which they referred to as a "fetal-infant growth graph". Babson and Benda (Babson) extended an intrauterine chart past term age by including a section based on the growth of infants born at term. Intrauterine growth charts allow this comparison for infants before term. Parents and health professionals like to know whether a preterm infant is able to maintain growth velocity or achieve catch-up in growth compared to the fetus and the term infant. Growth charts provide the basis for this assessment by providing a comparison to a reference which allows for a visual picture of both the infant's achieved size and growth trajectory. Growth monitoring is a part of the medical and nutritional assessment of preterm infants. Further validation is needed to illustrate the growth patterns of preterm infants to older ages. As with all meta-analyses, the validity of this growth chart is limited by the heterogeneity of the data sources. Comparison of the size of the NICHD infants at a weight of 2 kilograms provides evidence that on average preterm infants are growth retarded with respect to weight and length while their head size has caught up to birth percentiles. The updated growth chart allows a comparison of an infant's growth first with the fetus as early as 22 weeks and then with the term infant to 10 weeks. When the infants reached an average weight of 2 kilograms, those with a birthweight in the range of 700 to 1000 grams had achieved greater than the 10 th percentile on average for head growth, but remained below the 3 rd percentile for weight and length. The growth patterns of the NICHD infants deviated away from the curves of the chart in the first weeks after birth. Babson's 10 th percentiles fell between the new data percentiles: the 5th to 17th for weight, the 5th and 15th for head circumference, and the 6th and 16th for length. Mean differences between the curves of the two charts reached statistical significance after term. The new data produced curves that generally followed patterns similar to the old growth graph. To validate the growth chart the growth results from the National Institute of Child Health and Human Development Neonatal Research Network (NICHD) were superimposed on the new chart. Comparisons were made between the new chart and the Babson and Benda graph. Data were selected from population studies with large sample sizes. The literature was searched from 1980 to 2002 for more recent data to complete the pre and post term sections of the chart. The purpose of this study was to develop an updated growth chart beginning at 22 weeks based on a meta-analysis of published reference studies. Its limits include the small sample size which provides low confidence in the extremes of the data, the 26 weeks start and the 500 gram graph increments. The Babson and Benda 1976 "fetal-infant growth graph" for preterm infants is commonly used in neonatal intensive care.
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