Growth and Development of Preterm Infants

2022 22 Projects FLRF

In 2021, FLRF extended its support of INTERGROWTH-21st through a follow-on project led by the University of Oxford – Growth and Development of Preterm Infants Across the World: How Breastmilk Influences Infant Outcomes in Different Preterm Phenotypes. 

Breastmilk is vital for the nutritional, immunological, developmental and psychological benefits that impact long-term health and development, yet breastfeeding rates at hospital discharge and six months of age are shockingly low worldwide, especially for infants born preterm.

It is vital to monitor growth and development of preterm infants according to international standards to prevent incorrect diagnoses, which can result in unnecessary nutritional interventions that may contribute to lower levels of exclusive breastfeeding. Hence, the INTERGROWTH-21st resources

The follow-on project is being led by Professor Stephen Kennedy and Professor José Villar of the Nuffield Department of Women’s & Reproductive Health. They and a team of researchers are analyzing data focused on relationships and interactions between the use of breastmilk, breastfeeding, newborn body composition, early infant growth and morbidity, and fetal/newborn phenotypes (observable characteristics). Follow-up analysis on the health, nutrition and morbidity outcomes includes an exploration of the likely beneficial effects of breastfeeding on the neurodevelopment of infants whose intrauterine growth was restricted.

Collaborating with the University of Oxford are the University of California Berkeley, the Geneva Foundation for Medical Education and Research, the Global Health Research Services and the University of Zurich (Prof. Dr. med. Giancarlo Natalucci, Director of the Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth and Nutrition of the Newborn - LRF NGN).

This project seeks to enhance our understanding of the growth, nutrition and development of preterm infants worldwide. Ultimately, it aims to maximize the use of breastmilk for preterm infants and shift clinical care pathways to avoid nutritional patterns related to suboptimal outcomes like nutrition deficits, childhood overweight or obesity.

Green LJ, Kennedy SH, Mackillop L, Gerry S, Purwar M, Staines Urias E, et al. International gestational age-specific centiles for blood pressure in pregnancy from the INTERGROWTH-21st Project in 8 countries: A longitudinal cohort study. PLoS Med. 2021;18(4):e1003611. DOI: 10.1371/journal.pmed.1003611

Ohuma EO, Villar J, Feng Y, Xiao L, Salomon L, Barros FC, et al. Fetal growth velocity standards from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Am J Obstet Gynecol. 2021;224(2):208.e1-208.e18. DOI: 10.1016/j.ajog.2020.07.054

Fernandes M, Villar J, Stein A, Staines Urias E, Garza C, Victora CG, et al. INTERGROWTH-21st Project international INTER-NDA standards for child development at 2 years of age: an international prospective population-based study. BMJ Open. 2020;10(6):e035258. DOI: 10.1136/bmjopen-2019-035258

Drukker L, Staines-Urias E, Villar J, Barros FC, Carvalho M, Munim S, et al. International gestational age-specific centiles for umbilical artery Doppler indices: a longitudinal prospective cohort study of the INTERGROWTH-21st Project. Am J Obstet Gynecol. 2020;222(6):602.e1-602.e15. DOI: 10.1016/j.ajog.2020.01.012

Hirst JE, Knight HE, Ohuma EO, Dwyer T, Hennig BD, Papageorghiou AT, et al. Social gradient of birthweight in England assessed using the INTERGROWTH-21st gestational age-specific standard. Arch Dis Child Fetal Neonatal Ed. 2019;104(5):F486–92. DOI: 10.1136/archdischild-2018-315295

Villar J, Giuliani F, Figueras-Aloy J, Barros F, Bertino E, Bhutta ZA et al. Growth of preterm infants at the time of global obesity. Arch Dis Child. 2019 Aug;104(8):725-727. DOI: 10.1136/archdischild-2018-315006.

Villar J, Giuliani F, Barros F, Roggero P, Coronado Zarco IA, Rego MAS et al. Monitoring the Postnatal Growth of Preterm Infants: A Paradigm Change. Pediatrics. 2018 Feb;141(2). pii: e20172467. DOI: 10.1542/peds.2017-2467.

Villar J, Giuliani F, Bhutta ZA, Bertino E, Ohuma EO, Ismail LC et al. Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21st Project. Lancet Glob Health. 2015 Nov;3(11):e681-91. DOI: 10.1016/S2214-109X(15)00163-1.

Villar J, Ismail L, Victora C, Ohuma E, Bertino E, Altman D et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014 Sep 6;384(9946):857-68. DOI: 10.1016/S0140-6736(14)60932-6.

Bhutta ZA, Giuliani F, Haroon A, Knight HE, Albernaz E, Batra M et al. Standardisation of neonatal clinical practice. BJOG. 2013 Sep;120 Suppl 2:56-63, v. DOI: 10.1111/1471-0528.12312.

Villar J, Altman DG, Purwar M, Noble JA, Knight HE, Ruyan P et al. The objectives, design and implementation of the INTERGROWTH-21st Project. BJOG. 2013 Sep;120 Suppl 2:9-26, v. DOI: 10.1111/1471-0528.12047.

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