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Maternal and Child Health Bureau ~ 16

Example 2: Child with low birthweight

LH is a 3-year-old twin girl born at 27 weeks gestation with a birthweight of 1030 gm, appropriate for gestational age. All weight and length measurements were plotted using corrected age.

Corrected age is determined by subtracting the number of weeks premature from the infant's chronological age.

Corrected age = Chronological age - number of weeks premature

LH was born at 27 weeks gestation and is now 3 years (or 36 months or 156 weeks) past her date of birth:

Step 1:

40 weeks - 27 weeks = 13 weeks, or 3 months, 1 week premature.

Step 2:

corrected age = 156 weeks - 13 weeks = 143 weeks corrected age (33 months or 2 years, 9 months)

or

Step 2:

corrected age = 36 months - 3 months = 33 months corrected age

LH was walking with assistance at age 3 years. The length measure was used due to her lack of stability when standing.

Weight-for-age, length-for-age, and head circumference-for-age (not shown) are all consistently below the 5th percentile.

Weight to length relationship at age three was at the 10th percentile.

Because LH was born with a very low birthweight (VLBW <1500 grams), IHDP charts were also used to assess her growth.

Weight-for-age decreased from between the 5th and 25th percentiles at age 2 months (corrected age) to below the 5th percentile by age 21 months (corrected age).

Length-for-age decreased from between the 5th and 25th percentiles at age 11 months (corrected age) to below the 5th percentile by age 21 months (corrected age).

Head circumference-for-age decreased from the 5-25th percentile at age 2 months (corrected age) to below the 5th percentile.

Weight-for-length remained relatively constant, between the 10th and 25th percentiles.

Self-test: Child with spina bifida

MW is a 7 year, 10 month old male with spina bifida (myelomeningocele) in the high lumbar area. Physical activity is limited, but MW is able to use his arms and shoulders. He is unable to stand, so a stature measurement cannot be taken.

Which alternative to stature is most appropriate?

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