Francesca Giuliani1, Leila Cheikh Ismail2, Enrico Bertino1, Zulfiqar A Bhutta3, Eric O Ohuma4, Ilaria Rovelli1, Agustin Conde-Agudelo5, José Villar2, Stephen H Kennedy6. 1. Department of Public Health and Pediatrics, University of Turin, Turin, Italy; 2. Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom; 3. Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan; Center for Global Child Health, Hospital for Sick Children, Toronto, Canada; 4. Nuffield Department of Obstetrics & Gynaecology, and Centre for Statistics in Medicine, University of Oxford Botnar Research Centre, Oxford, United Kingdom; 5. 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. 6. 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.
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. DESIGN: 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.
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. DESIGN: 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: Li Zhang; Nan-Nan Gao; Hui-Juan Liu; Qiong Wu; Ju Liu; Ting Zhang; Jin Sun; Jian-Hong Qi; Xiu-Yun Qiao; Yan Zhao; Yan Li Journal: Front Pediatr Date: 2022-06-13 Impact factor: 3.569