The Reproductive Care Program develops, produces and distributes chart forms to Nova Scotia hospitals that provide perinatal services. These forms are regularly reviewed to ensure their content reflects current evidence and promotes best practice. This review process may result in minor changes for specific chart forms, or major revisions which sometimes result in a very different look. While all changes are important to highlight, those that significantly change the appearance of a familiar chart form warrant a detailed explanation for users.
The Atlantic Newborn Male and Female Growth Charts are familiar to users at most facilities across Nova Scotia and have remained virtually unchanged for decades, as they were developed from data gathered and analyzed over fifty years ago. Overall, the growth patterns on these chart forms are no longer reflective of the best available data. At the time these forms were originally developed management of pregnancy, and neonatal outcomes and approaches to care were significantly different for infants at either extremes of gestational age and so these populations are under- or misrepresented in the data, as compared to today.
Revisions to RCP’s newborn growth charts were undertaken with an approach that included a review of the literature, an environmental scan and consultation with content experts and comparable organizations. After considering the available options and the needs of Nova Scotia’s newborn population, particularly preterm infants, the RCP has decided to adopt the Fenton Preterm Growth Charts (http://ucalgary.ca/fenton/2013chart) as they align with the WHO growth charts, cover earlier as well as later gestations and provide all growth parameters on one form. This is endorsed by the Dieticians of Canada and has been adopted by many agencies within and outside of Canada. Links to the data and literature supporting the development of this form are provided on the website listed above.
The World Health Organization released Growth Standards (WHO-GS) which have been widely accepted as the new standard of care for measuring and monitoring all infants and children. Preterm infants are to be measured using corrected age until 24-36 months. However, because the WHO-GS are based on the data from healthy, term, exclusively breastfed babies, there are no values for preterm gestations.
The most recent revision of the Fenton growth charts for preterm infants provides for both sexes, and the developer has smoothed the preterm growth data to accommodate the World Health Organization Growth Standards. These become equal at 50 weeks gestation (or 10 weeks corrected age). Weight, height, and length are all recorded on one chart, and the RCP provides the chart for boys on one side and girls on the other.