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* * ? 2011 Royal College of Paediatrics and Child Health, 3RD edition Spring 2011. www.growthcharts.rcpch.ac.uk An Introduction to the UK-WHO Neonatal and Infant Close Monitoring (NICM) Growth Chart Definitions and Terminology Gestational age: time elapsed between the first day of the last menstrual period and the day of delivery Preterm: birth date before 37 completed weeks gestation Number of weeks preterm: 40 weeks minus gestational age Chronological age: time elapsed since birth Postmenstrual age: gestational age plus chronological age in weeks Corrected age: chronological age minus number of weeks preterm American Academy of Pediatrics, Pediatrics 2004;114:1362-4 Special features of the NICM Chart A date box system to aid accurate calculation of gestational age Calculating corrected age is difficult and prone to mistakes Arrow drawn back method of gestational age correction not practical for very early gestations Large scale Extra low reading (-3, -4, -5 SD) lines to allow assessment of very small infants Does not require gestational age correction as time axis is continuous from birth When to use the NICM chart Infants born before 32 weeks gestation Unwell infants born 32-36 weeks gestation Term unwell neonates needing close monitoring e.g. those with cardiac or renal disease Infants with significant growth or weight faltering Data sources for the NICM Chart 23 weeks gestation to 42 weeks: Reanalysed UK1990 data Describes size at birth only Does not describe how preterm infants should grow 2 weeks to 2 years corrected age charts: WHO growth standard Special features: Large scale SD lines for assessment of very small infants Date boxes Birth weight, and HC for gestation from 23 weeks to 42 weeks, length from 26 weeks Infancy chart starts at 2 weeks Head and length curves in reverse order to fit on page Preparing the chart using date boxes Start with either a) estimated date of delivery (EDD) or b) date of birth and known or estima