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Here’s a detailed overview of the paper “Fenton Third‑Generation Growth Charts of Preterm Infants Without Abnormal Fetal Growth: A Systematic Review and Meta‑Analysis” by Fenton, Elmrayed & Alshaikh (online June 19, 2025):
📌 Citation & Background
Fenton et al. present a systematic review and meta-analysis aimed at revising the widely-used Fenton preterm growth charts. These new third-generation, sex-specific charts focus on infants who had healthy fetal growth—excluding those with abnormal fetal trajectories—to more accurately assess preterm growth patterns (pubmed.ncbi.nlm.nih.gov).
🧪 Methods
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Search scope: From the last Fenton update (2013) to November 2024, covering MEDLINE, EMBASE, grey literature, US vital records, and the iNeo Consortium (pubmed.ncbi.nlm.nih.gov).
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Inclusion: Population-based cohorts with gestational age ≤24 weeks, birth data (<42 weeks), healthy fetal growth metrics (birthweight, length, head circumference).
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Analysis: Meta-analysis calculated weighted averages harmonised with WHO growth standards; the x-axis was refined to exact gestational age (weeks + days) (pubmed.ncbi.nlm.nih.gov).
🌍 Data Sources
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Seven studies across 15 countries (Australia, Brazil, Canada, China, Finland, Israel, Italy, Japan, Netherlands, New Zealand, Sweden, Switzerland, Spain, UK, USA).
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Total: ~4.8 million births between 22–42 weeks gestation, including ~174,000 very preterm infants (<30 weeks) (pubmed.ncbi.nlm.nih.gov).
📈 Key Results
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The new charts show more uniform growth trajectories across percentiles, reflecting smoother, physiologically plausible declines in weight, length, and head circumference velocity as post‑menstrual age advances (pubmed.ncbi.nlm.nih.gov).
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Birthweight curves now align more closely with fetal ultrasound estimates, offering improved external validity (pubmed.ncbi.nlm.nih.gov).
🧭 Conclusions
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These third-generation growth charts present refined slopes and velocities, aligning better with intrauterine growth patterns and aiding in more precise growth monitoring of preterm infants.
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They represent a new recommended standard for clinicians enhancing the assessment of postnatal growth trajectories in preterm babies (pubmed.ncbi.nlm.nih.gov, spneonatologia.pt).
🌟 Significance for Clinical Practice
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Offers a more biologically plausible tool for monitoring preterm infant growth versus previous charts or term-based standards.
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By excluding infants with abnormal fetal growth, these charts serve as a purer reference for healthy growth trajectories.
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Enhanced precision in detecting growth faltering may improve timely interventions and nutritional adjustments.
Would you like to discuss:
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Details on chart implementation (e.g., download links/tools)?
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Comparisons with previous Fenton versions (e.g., 2013 chart)?
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Clinical implications for specific gestational ages or settings?
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