Updated gestational age specific birth weight,crown-heel length,and head circumference of Chinese newborns

OBJECTIVE: To construct gestation specific standards of birth weight, crown-heel length, and head circumference of Chinese infants. DESIGN: A prospective cross sectional population study. METHODS: The birth weight, crown-heel length, and head circumference were prospectively measured using standard equipment in newborns delivered at 24-42 weeks gestation in the maternity units of 10 public hospitals and two private hospitals in Hong Kong. The findings were used to construct gestation specific standards of these variables. The LMS method using maximum penalised likelihood was used to perform model fitting. The results were compared with those obtained from a cohort of infants born in the same locality between 1982 and 1986. RESULTS: From October 1998 to September 2000, a total of 10 032 infants were measured, representing 9.6% of the total deliveries in Hong Kong during that period. An extra 307 infants with gestation < or = 35 weeks were recruited from October 2000 to June 2001. Each of the three variables showed a normal distribution at each gestational week. Gestation specific reference standards for each variable were constructed for male and female infants separately. Comparison with the 1982-1986 cohort showed a significant secular trend to increased birth weight. The trend was small, but significant, for crown-heel length and head circumference. CONCLUSION: These growth standards will provide useful references for the care of newborns of ethnic Chinese origin. These standards, especially that for birth weight, should be updated regularly.     

Anthropometric parameters of Zambian infants at birth

Mean, standard deviations, and percentile values for weight, length, head, chest, and mid-arm circumferences were calculated by measuring 2353 'normal' singleton babies born at University Teaching Hospital (UTH), Lusaka, Zambia. The mean values were as follows: birth weight 3.08 +/- 0.40 kg; crown-heel length 48.57 +/- 2.53 cm; head circumference 34.55 +/- 1.57 cm; chest circumference 32.14 +/- 1.92 cm; and mid-arm circumference 10.68 +/- 0.96 cm. Physical measurements increased with increase in gestational age up to 42 weeks and male babies were larger than their female counterparts.     

早产儿校正24月龄内生长轨迹研究（英文翻译）

目的分析早产儿校正24 月龄内生长轨迹,以了解早产儿的生长趋势和规律。方法基于互联网+ 随访系统建立早产儿随访数据库,纳入2018 年4 月至2021 年4 月3 188 例早产儿,收集其出生及校正1、3、6、 12、18、24 月龄时的身长、体重、头围数据。按不同的围生期因素分组,绘制生长曲线,并与21 世纪国际胎儿和新生儿生长联合会（International Fetal and Newborn Growth Consortium for the 21st Century,INTERGROWTH-21st）标准和世界卫生组织（World Health Organization,WHO） 标准进行比较。结果按不同的围生期因素分组的各组早产儿体重、身长、头围曲线均在校正6 月龄内快速上升,校正6 月龄后增长速度减缓。按实际月龄比较,各出生胎龄组早产儿（<28 周、28~31⁺⁶周、32~33⁺⁶周、34~36⁺⁶周） 身长曲线在实际9 月龄后逐渐与WHO 曲线重合（P=0.082）,<32 周早产儿的体重和头围则一直落后于WHO 曲线（P<0.001）。校正月龄后,不同出生胎龄组早产儿（<28 周、28~31⁺⁶周、32~33⁺⁶周、34~36⁺⁶周） 的体格生长曲线基本重合（P>0.05）。超低出生体重儿和小于胎龄儿的身长、体重、头围曲线均低于INTERGROWTH-21st 标准和WHO 标准（P<0.05）。结论早产儿在校正6 月龄内体格增长速度较快,校正6 月龄后增长速度减缓。胎龄越小,体重和头围追赶的时间越长。应重点关注超早产儿、超低出生体重儿和小于胎龄儿的体格生长。     

Size at Birth in Iceland

ABSTRACT. Anthropometric standards for weight, length and head circumference of Icelandic infants at birth are presented. The material concerning weight and crown-heel length consisted of 43364 newborns, the total number of infants born in 1972-1981. The standards for head circumference were based on 28978 infants born in 1975-1981. Multiple births and stillbirths were excluded from the material, leaving single livebirths with an estimated length of gestation of 28-44 weeks. No further exclusions were made. The material was compared with previous standards used in Iceland as well as with other studies of all single livebirths in geographically defined populations. Standards for crown-heel length and head circumference were compared with other studies based on more limited and selective materials. The differences between these studies emphasize the need for an international agreement on the methodology for measurement and recording of infant growth during the perinatal period.     

Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements

Anthropometric measurements were obtained within 12 h of birth in 52 infants of non-diabetic mothers and 61 infants of diabetic mothers. Most of the diabetic patients were under good control, only ten of 61 having postpartum hemoglobin A1c levels in excess of normal. Neonates were grouped as normally-grown or macrosomic. Birthweight, crown-heel length, head circumference and skinfold thickness were measured. In each diabetes class, macrosomic neonates had larger mean length, head circumference and skinfold thickness than their normally-grown peers. At equal birthweight, neonates of gestational diabetic mothers and of non-diabetic mothers were similar in length, head circumference and skinfold thickness. Neonates of permanently insulin-requiring diabetics were similar to their non-diabetic peers in length and head circumference but had thicker skinfold thicknesses. Anthropometric measurements do not permit differentiation of the origin of neonatal macrosomia.     

Growth of low-birth-weight infants

Growth in weight, length, and head circumference were compared among 3 different groups of infants. These measurements for each group were also compared to those presumed representative for the average fetus and infant of corresponding gestational age. A graph was prepared to show curves of fetal growth in the 3 parameters for the last trimester of pregnancy and through the 1st year of life after the equivalent age of "term" has been reached. The composite curves of the 3 groups were compared from the time of birth with no correction for gestational age. Since 1962 all low birthweight infants admitted to the Premature Center of the University of Oregon Medical School have been measured longitudinally for weight, length, and head circumference. 3 weight gestation groups were selected for study: Group A, very premature with weight appropriate for gestational age, gestation 27-29 weeks, birth weight .95-1.30 kg; Group B, moderately premature, with weight appropriate for gestational age, gestation 31-33 weeks, birth weight 1.40-2.00 kg; and Group C, full term, but severely underweight for gestational age, 38 weeks or more, birth weight less than 2.00 kg. Weight was obtained from an automatic Toledo balance scale, accurate to 10 gm. The babies were weighed prior to the morning feeding. Since measurements could not be made at precisely the same age for all infants after discharge from the hospital, derived measurements for appropriate intervals of time were extrapolated from the curves of growth of each infant. For estimation of fetal growth in weight, length, and head circumference, data were obtained from measurements reported in the literature for infants of known gestational age. After a 2-week lag, the curves for weightand length of Groups A and B paralleled those for standard fetuses and infants thoughout the 1st year of life. The curves were at a lower level with the curve of the most immature group (A) being reduced the most. Head circumference, after a 2-week lag, regained and followed the projectedcurve, suggesting a temporary acceleration in the growth of the head. This was in contrast to growth in length. Growth in Group C, after a lesser interruption following birth, also paralleled the mean curves of full-sized infants, but at a level substantially below them as well as those forthe Groups A and B. The curve for head growth in Group C gradually approached that of full-sized infants, but the significant disparity in head size from the normal-sized infant at birth was only partly reduced by the end of the 1st year. From the data it appears that little, if any, of the retardation in weight and length that may be suffered in the fetal or neonatal period is made up during the 1st year of life if the infant's age is corrected to term.     

Fetal growth: relationship with maternal dietary intakes

One hundred urban and 85 rural pregnant women in third trimester were subjected for the studies of dietary intakes and the body size (weight for height ratio index). The intrauterine growth of newborn infants was assessed at birth by weight, crown-heel length and head circumference. The fetal growth improved significantly with increasing maternal caloric and protein intakes. The mean values of weight, crown-heel length and head circumference of newborn infants were significantly higher in mothers receiving more than 2000 kcals and 75g of proteins as compared to the mean values observed for newborns of mothers with dietary caloric and protein intakes less than 1500 kcals and 45.0g respectively in both urban and rural subjects. No significant difference was observed in the growth parameters of newborn infants with further increase in the maternal caloric intake above 2000 kcals. Further the total protein intake influenced the newborn's weight significantly irrespective of the animal protein content.     

Placental size of small-for-gestational-age infants at term

Placental size was compared between appropriate-for-gestational age (AGA) and small-for-gestational age (SGA) infants born at term. Placental weight, chorionic plate area and villous surface area were significantly reduced in the SGA infants. Although the ratio of placental weight to birth weight was similar in the AGA and SGA infants, the latter had significantly underweight placentas for their head circumference and crown-heel length. The ratios of placental weight to assessed brain weight and villous surface area to assessed brain weight were also significantly reduced in the SGA infants. It is concluded that the study SGA infants had both absolutely and relatively small placentas.     

Protein intake affects phenylalanine requirements and growth of infants with phenylketonuria

Growth and metabolic status of 25 infants with PKU were evaluated based on protain intake. Food A-fed infants received a medical food containing 3.12g protein equivalent per 100 kcal and Food B-fed infants received a medical food containing 2.74 g protein equivalent per 100 kcal. Growth percentiles of infants in the Food A group were significantly greater than those for infants in the Food B group at 6 months of age (Food A percentiles: crown-heel length 55, head circumference 60, weight 73. Food B percentiles: crown-heel length 28; head circumference 29, weight 39). At study entrance, only crown-heel length of the two groups differed; Food B infants had a significantly greater mean crown-heel length percentile ( p < 0.05). Mean phenylalanine (PHE) intake was 38% greater by Food A-fed infants than by Food B-fed infants. Plasma PHE concentrations and mean energy intakes of the two groups did not differ. Mean protein intake of Food A-fed infants was greater during the first three months of life and significantly greater ( p < 0.05) during the second three months of life than by Food B-fed infants. Mean protein intake 24% greater than Recommended Dietary Allowances (RDA) was associated with better PHE tolerance and growth than was found when mean protein intake was 9% greater than RDA.     

13776例不同胎龄正常足月儿身长胸围指数研究

目的获得不同胎龄正常足月儿身长胸围指数。方法采用横断面时间段整群取样现场调查方法,于2013—2015年完成16 388例不同胎龄新生儿的体质量、身长、顶臀长、头围、胸围的现场测量,用以制定不同胎龄正常足月儿身长胸围指数。结果最终获得正常足月儿13 776例的测量数据。随着胎龄增加,新生儿出生时身长胸围指数(BCI)、维尔维克指数(VI)、艾里斯曼指数(EI)均有所递增。男婴BCI、VI、EI小于女婴,差异有统计学意义(P0.05)。2015年的新生儿BCI、VI、EI与2005年有一定的差异。结论不同胎龄正常足月儿随胎龄增大胸廓丰满度不断提高,男性低于女性,本次数据与十年前相比有一定的差异。     

Catch up Growth in Preterm Infants

Seventy-one surviving infants were followed up from birth to 24 weeks of postnatal age. Their mean gestational age was 32 weeks with a range of 26–36 weeks and a standard deviation of 2.1 weeks. Their mean birth weight was 1.805 kg with a range of 0.675–2.5 kg and a standard deviation of 0.408 kg. Their weights, lengths and head circumferences were measured at birth, 6, 12 and 24 weeks. Curves for the mean weight, length and head circumference were produced and superimposed on the available intrauterine and extra-uterine growth charts. The growth curves of the preterm infants did not show the flattening noted in the intrauterine curves towards term. The curve of the mean weight of the preterm infants started at the 50th centile for Gairdner & Pearson (1971) at birth to drop below that shortly after birth. At 40 weeks of postconceptional age the mean weight curve of preterm infants crossed the 50th centile and continued above it to reach the 90th centile at 60 weeks. The curves of mean length and head circumference started below the 50th centile at birth and crossed it at 40 weeks and continued above it to approach the 90th centile at 60 weeks. Growth velocity was calculated as a relative gradient using the straight line equation (y=a+bx), where y is the weight, length or head circumference, and x is the independent variable and here it is the group mean of the parameter at the corresponding ages. Catch up growth is taken as a relative gradient significantly greater than one. The first 24 weeks of postnatal life are defined as a period of catch up growth with the first 8 weeks as an interval of maximum head velocity.     

Judging fetal growth from body proportions at birth.

Fetal growth velocity from 27 weeks until birth was calculated in 378 infants born after high risk pregnancies from at least three ultrasound measurements of estimated fetal weight and the weight at birth. Anthropometric measurements at birth (weight, head circumference, length, ponderal index and skinfolds), after correction for differences in gestational age, were significantly related to fetal growth velocity. The relation between fetal growth velocity and ponderal index was significant (correlation coefficient = 0.34, P < 0.001). However, the correlations between fetal growth velocity and each of the anthropometric measures disappeared when birth weight relative to gestational age was accounted for. This means that given the birth weight and the gestational age of a newborn infant, body proportions, e.g. ponderal index or skinfold thickness, do not contribute further to the judgment about fetal growth rate.     

晚期早产儿体格生长的前瞻性研究

目的：评价不同胎龄晚期早产儿（late preterm infants, LPI）的出生体重（birth weight, BW）和矫正胎龄（correct age, CA）1、3、6月龄时的体格生长情况,为早产儿长期体格生长随访提供监测重点。方法：收集2010年5月至2011年9月就诊的287例LPI相关资料,评价LPI的BW和其在CA 1、3、6月龄时的体格生长情况。结果：（1）287例LPI中,胎龄34~34+6周和35~35+6周LPI平均BW低于1986年中国15城市不同胎龄新生儿参考值（P<0.05）;胎龄36~36+6周单胎LPI(128例)平均BW高于1986年中国15城市不同胎龄新生儿参考值（P＜0.05）。（2）在CA 1、3、6月时,90%以上LPI的各项生长指标达到或超过P3水平。CA 1、3月龄时,年龄别体重和头围明显大于2005年我国九市城区7岁以下正常儿童参考值（P＜0.05）。（3）各CA的年龄别身长与参考值差异均无统计学意义。结论：与1986年中国15城市不同胎龄新生儿BW值比较,LPI的BW有变化,提示我国不同胎龄新生儿BW标准需间隔一定时间后重新调查制定。LPI 在CA 6月龄前存在超重的危险,需要更长期的监测。LPI的身长的生长应作为今后LPI生长随访监测的重点。     

Mid-arm circumference/head circumference ratios for identification of symptomatic LGA, AGA, and SGA newborn infants

Mid-arm circumference/head circumference ratios (MAC/HC) and birth weights obtained in 73 neonates were studied to compare which of these growth measurements could more accurately predict risk of metabolic complications resulting from either acceleration or retardation of fetal growth. The MAC/HC ratio was more sensitive than birth weight in distinguishing symptomatic large for gestational age (LGA) infants who were born to diabetic mothers from other LGA infants who were asymptomatic, and symptomatic from asymptomatic small for gestational age infants. In addition, the MAC/HC ratio identified symptomatic appropriate for gestational age (AGA) infants born to diabetic mothers and AGA infants with signs and symptoms of growth retardation. The MAC/HC is more useful than birth weight in assessing newborn infants at risk for the metabolic complications associated with fetal growth disorders.     

84例早产适于胎龄儿第一年体格追赶生长纵向评估

目的：分析早产适于胎龄儿1岁以内的追赶生长特点,探讨其追赶生长规律。方法：选择84名胎龄28～36周的早产适于胎龄儿（男44例,女40例）作为研究对象,对其0～12月内的体重、身长及头围分别按实际月龄足月儿生长标准和纠正月龄标准进行Z评分评估并分析。结果：早产适于胎龄儿1岁内体重、身长和头围均出现追赶性生长,且增长最快的阶段均在实际月龄0～3月,体重追赶速度优于身长追赶速度。结论：生后前3个月是早产适于胎龄儿的快速生长期;体重与身长的变化存在不平衡性。     

The relative contribution of birth weight and gestational age to physical traits of newborn infants

The present study establishes anthropometric standards for newborn infants, born between 26-41 weeks of gestational age. The measurement of 10 standard anthropometric traits was made within the first 72 hours of life in 224 preterm (26-36 weeks) and 190 term (37-41 weeks) infants. Multiple regression analysis was carried out for each of these anthropometric traits (dependent variables) on gestational age, birth weight and sex (independent variables). It was found that the prediction of several traits, namely, body length, body mass index, body surface area, interocular diameter, ear length and palm length, can be done solely via the information on birth weight; cephalic index is better predicted on the basis of gestational age, while for the prediction of such cranial traits as the circumference, length and breadth of head, both birth weight and gestational age are desirable.     

Infants with birth weights less than 1,001 g. Survival, growth, and development

Of 56 infants weighing less than 1,001 g who were born in 1980, 30 (54%) survived the neonatal period and 29 (52%) survived the first year. At 12 to 16 months of age, 44% of the measured survivors were below the fifth weight percentile and 32% were below the fifth head circumference percentile for their adjusted ages. Of the first-year survivors, 21 (72%) were developmentally normal, four (14%) were mildly handicapped, and four (14%) were moderately to severely handicapped at 12 to 34 months of age. Handicapped infants differed significantly from normal infants in their neonatal requirements for mechanical ventilation, but did not differ in birth weight, gestational age, route of delivery, Apgar scores, maternal age or marital status, maternal education or income, gender, race, place of birth, or proportions below the tenth percentile in weight or head circumference at birth.     

Extrauterine growth restriction in preterm infants of gestational age < or =32 weeks

BACKGROUND: Extrauterine growth restriction (EUGR) in low-birthweight (LBW) infants affects their growth and developmental prognoses as well as their incidence of adult diseases. The aim of the present paper was to determine the frequency and contributing factors of EUGR in infants > or =32 weeks of gestational age. METHODS: The subjects consisted of 416 infants from 22 facilities born between February and October 2002, whose gestational age was > or =32 weeks. For EUGR assessment, subjects whose body measurements in the 37-42 week postmenstrual age (PMA) period were below the 10th percentile of the standard normal distribution, were selected. RESULTS: EUGR incidence rates for weight, length, and head circumference were 57%, 49%, and 6%. In appropriate-for-gestational-age infants, a negative correlation was found between number of gestational weeks and EUGR incidence rates for weight, length, and head circumference, but in small-for-gestational-age infants this was true only for head circumference. Lower gestational age and age in days to achieve complete feeding were among the shared factors contributing to EUGR incidence for weight, length, and head circumference. The significant factors for EUGR incidence for weight and length included whether the infant was small for gestational age, whether oxygen was administered at 36 weeks PMA, age in days at which breast-feeding was initiated, and age in days when the infant regained birthweight. CONCLUSIONS: The growth retardation of preterm LBW infants in the neonatal intensive care unit continues to pose challenges. Relevant factors other than gestational age include intrauterine growth restriction, severe chronic lung disease, and poor nutrition.     

A prospective study on the intrauterine growth of Hong Kong Chinese babies

A prospective study on the birth weight, crown-heel length and head circumference of 8,445 singleton Chinese newborn infants born between 27 and 42 weeks of gestation was conducted in three major regional maternity units in Hong Kong over a 3 1/2-year period. The data were used to construct centile charts for the intrauterine growth of each physical measurement. By careful gestational assessment of the infants, primary exclusion of pregnancies complicated by abnormal fetal or maternal conditions that might have affected fetal growth together with infants of doubtful maturity, these curves depict more accurately the prenatal growth of Chinese infants than those previously published in studies on similar populations of infants. Chinese infants, as shown by the findings of the present study, are similar in their mean weight to Japanese infants and American infants in Denver but are lighter than British and Australian infants, as well as American infants born at sea level.     

Growth Pattern of Intrauterine Growth Retarded (IUGR) Babies in First Nine Months of Life

ABSTRACT. Forty-one full term intrauterine growth retarded (IUGR) babies of different maternal etiologies viz. maternal undernutrition (12), small maternal size (12), toxaemia of pregnancy (9) and idiopathic (8) were studied for growth pattern during first 9 months of life. Eighteen fullterm and 11 preterm who were appropriate for gestational age served as controls. These mothers were comparable for age, parity, socioeconomic status, weight and height (except in small size mothers), haemoglobin and plasma albumin (except in undernourished group). The various anthropometric parameters studied were weight, crown-heel length, head circumference, their velocities and ponderal index. The IUGR babies of undernourished mothers had lowest means for weight, crown-heel length and skull circumference. The babies of small sized mothers suffered most in crown-heel length followed by weight. The head growth was not affected in these babies. The IUGR babies of mothers with toxaemia of pregnancy demonstrated a catch up growth for all three parameters. The IUGR babies of idiopathic group showed a spurt in weight gain around 3 to 6 months and a similar spurt for crown heel length and head circumference was observed between 6 to 9 months of age. These babies were close to IUGR babies of mothers with toxaemia of pregnancy at 9 months. The preterm AGA babies also demonstrated a catch up growth for the weight, crown heel length and circumference.