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Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
Patterns Of Growth
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Patterns Of Growth

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Different Patterns of growth in Children

Different Patterns of growth in Children

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  • 1. Patterns of Growth Crisbert I. Cualteros, M.D.
  • 2. Classification by weight groups: <ul><li>Low birth weight (LBW) </li></ul><ul><li>BW < 2,500 g </li></ul><ul><li>2. Very low birth weight (VLBW) </li></ul><ul><li>BW < 1,500 g </li></ul><ul><li>Extremely low birth weight (ELBW) </li></ul><ul><li>BW < 1000 g </li></ul>
  • 3. Classification by weight groups: <ul><li>Objective: </li></ul><ul><li>Establish level of risk for neonatal and long-term morbidity and mortality </li></ul>
  • 4. Measurement Techniques <ul><li>Crown-heel length </li></ul><ul><ul><li>Infant supine, neck neutral, leg fully extended and the ankle flexed </li></ul></ul><ul><ul><li>Most subject to variability </li></ul></ul><ul><li>Head circumference </li></ul><ul><ul><li>Occipital frontal circumference </li></ul></ul><ul><ul><li>Largest dimension around the head, tape placed snugly above the ears </li></ul></ul><ul><ul><li>Predictably falls on the same percentile curve as the length </li></ul></ul>
  • 5. Interpretation of Growth Curves <ul><li>Appropriate for Gestational Age (AGA) </li></ul><ul><ul><li>Birth weight falls between the 10 th and the 90 th percentiles for a given gestational age </li></ul></ul><ul><li>Small for Gestational Age (SGA) </li></ul><ul><ul><li>less than the 10 th percentile </li></ul></ul><ul><li>Large for Gestational Age (LGA) </li></ul><ul><ul><li>more than the 90 th percentile </li></ul></ul>
  • 6. Interpretation of Growth Curves <ul><li>4. IUGR ( Intrauterine Growth Restriction) </li></ul><ul><ul><li>Slowing of intrauterine growth rate documented by serial fetal sonography or a presumed slowing by very low weight for length measurements </li></ul></ul>
  • 7. Types of IUGR <ul><ul><li>a. Symmetric IUGR </li></ul></ul><ul><ul><ul><li>if the 3 parameters of weight, length and head circumference fall on the same curve </li></ul></ul></ul><ul><ul><li>b. Asymmetric IUGR </li></ul></ul><ul><ul><ul><li>if the parameters are on different curves, usually with the weight on a curve lower than those of the head circumference or length </li></ul></ul></ul>
  • 8.  
  • 9. IUGR <ul><li>In general: </li></ul><ul><ul><li>Factors intrinsic to the fetus cause symmetric growth restriction </li></ul></ul><ul><ul><li>External factors cause asymmetric growth restriction </li></ul></ul>
  • 10. Patterns of Growth <ul><li>Symmetric growth restriction </li></ul><ul><li>Develop early during fetal life (intrinsic nature) </li></ul><ul><li>Factors that limit growth of both the fetal brain and body: </li></ul><ul><ul><li>Chromosomal anomalies (trisomy conditions) </li></ul></ul><ul><ul><li>Congenital infections -(CMV, toxoplasma, rubella) </li></ul></ul><ul><ul><li>Dwarf syndromes </li></ul></ul><ul><ul><li>IEM </li></ul></ul><ul><ul><li>Some drugs </li></ul></ul><ul><ul><ul><li>Mechanisms by which these factors limit fetal growth are MULTIFACTORIAL </li></ul></ul></ul>
  • 11. Patterns of Growth <ul><li>Asymmetric growth restriction </li></ul><ul><li>Develop as early as 2 nd trimester </li></ul><ul><li>Classically develops during the late 2 nd and 3 rd trimesters </li></ul><ul><li>Reductions of energy substrate supply to the fetus limit fat and glycogen storage and the growth of skeletal muscle, but allow for continued brain and bone growth </li></ul>
  • 12. Clinical significance <ul><li>AGA born at term are at lowest risk for problems associated with neonatal mortality and morbidity </li></ul><ul><li>SGA, IUGR, LGA are at risk for perinatal and long term problems </li></ul>
  • 13. Clinical significance <ul><li>Symmetric growth restriction </li></ul><ul><ul><li>May have little chance for postnatal catch-up growth after an early, global disruption of growth </li></ul></ul><ul><li>Asymmetric growth restriction </li></ul><ul><ul><li>Has a reasonable potential for catch-up growth and normal development </li></ul></ul>
  • 14. Please visit: PLEASE VISIT: http://crisbertcualteros.page.tl

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