Children born preterm, low birth weight (LBW) or with other perinatal risk factors are at high-risk of malnutrition. Regular growth monitoring and early intervention are essential to promote optimal feeding and growth; however, monitoring growth in preterm infants can be complex. This study evaluated growth monitoring of infants under 6 months enrolled in Paediatric Development Clinics (PDCs) in rural Rwanda. We reviewed electronic medical records (EMR) of infants enrolled in PDCs before age 2 months with their first visit between January 2015 and December 2016 and followed them until age 6 months. Nurse classification of anthropometric measures and nutritional status were extracted from the EMR. Interval growth and length-for-age, weight-for-length, and weight-for-age z-scores were calculated using World Health Organization anthropometry software as a 'gold standard' comparison to nurse classifications. Two hundred and ninety-four patients enrolled and had 2,033 visits during the study period. Referral reasons included prematurity/LBW (73.8%) and hypoxic ischemic encephalopathy (28.2%). Nurses assessed interval growth at 58.7% of visits, length-for-age at 66.4%, weight-for-length at 65.6% and weight-for-age at 66.4%. Nurses and gold standard assessment agreed on interval growth at 53.3% of visits and length-for-age at 63.7%, weight-for-length at 78.2% and weight-for-age at 66.3%. At 6 months, 46.5% were stunted, 19.9% were wasted and 44.2% were underweight. There were significant challenges to optimizing growth and growth monitoring among high-risk infants served by PDCs, including incomplete and inaccurate assessments. Developing tools for clinician decision support in assessing growth and providing specialized nutritional counselling are essential to supporting optimal outcomes in this population.

中文翻译：

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卢旺达新生儿随访诊所中婴儿的营养评估和生长。

早产、低出生体重 (LBW) 或具有其他围产期危险因素的儿童处于营养不良的高风险中。定期的生长监测和早期干预对于促进最佳喂养和生长至关重要；然而，监测早产儿的生长情况可能很复杂。本研究评估了在卢旺达农村地区儿科发育诊所 (PDC) 登记的 6 个月以下婴儿的生长监测。我们审查了在 2 个月前加入 PDC 并在 2015 年 1 月至 2016 年 12 月期间首次就诊的婴儿的电子病历 (EMR)，并跟踪他们直至 6 个月大。从 EMR 中提取了护士对人体测量和营养状况的分类。间隔增长和年龄别身长、身长别体重、使用世界卫生组织人体测量学软件计算年龄别体重 z 分数作为与护士分类的“黄金标准”比较。在研究期间，共有 294 名患者入组并进行了 2,033 次访问。转诊原因包括早产/LBW (73.8%) 和缺氧缺血性脑病 (28.2%)。护士评估的间隔增长为 58.7%，年龄别身长为 66.4%，身长别体重为 65.6%，年龄别体重为 66.4%。护士和金标准评估同意间隔增长为 53.3%，年龄别身长为 63.7%，身长别体重为 78.2%，年龄别体重为 66.3%。6 个月时，46.5% 发育迟缓，19.9% 消瘦，44.2% 体重不足。在 PDC 服务的高危婴儿中优化生长和生长监测存在重大挑战，包括不完整和不准确的评估。开发用于评估生长和提供专业营养咨询的临床医生决策支持工具对于支持该人群的最佳结果至关重要。