An Open-Source Platform to Guide Implementation of the Postnatal Growth Charts for Preterm Infants

Abstract

Abstract Background Determining adequate growth in preterm infants poses challenges due to limited assessment tools. The American Academy of Pediatrics' goal to achieve postnatal growth approximating intrauterine growth lacks clear physiological and clinical support. Recently, Chou et al. aimed to characterize postnatal growth of preterm infants, and revealed distinct postnatal growth trajectories, challenging prior goals of assimilating intrauterine growth. Specifically, the study analyzed 89,218 preterm infants born between 2010 and 2020, grouped by sex and gestational age, and identified three phases of postnatal growth. This project aims to develop digital applications and interface to provide target audience with convenient access to the postnatal growth models for clinical, research, quality improvement use. Implementation Given the number of models developed to cover a wide range of gestational age groups, the Postnatal Growth Charts for Preterm Infants can only be used in a digital format. The open-source framework targeted neonatal care providers, researchers, and families, allowing growth chart access for clinical, research, and quality improvement purposes. The implementation of trajectory percentile calculation as well as various downstream applications will aide neonatal providers in growth prediction, growth goal-setting, post-illness nutrition guidance, and facilitating growth chart transitions when the infants reach term-equivalent age. Conclusions The web-based applications and application programming interface functions may serve clinical, research, and programming needs, and encourage an institutional electron health records integration. By offering realistic references, facilitating peer-to-peer comparisons, and acknowledging measurement errors, this tool empowers neonatal care providers to monitor preterm infant growth more confidently. Using the Postnatal Growth Charts of Preterm Infants may support personalized nutrition regimens and minimize long-term health risks. The open-source nature encourages widespread utilization and may further innovations in neonatal care and research.