INTERPRACTICE-21st

Implementing the INTERGROWTH-21st Preterm Postnatal Growth Standards

The INTERPRACTICE-21st Project promotes the optimal postnatal growth of preterm infants and standardises growth measurement in selected populations around the world. It is based on the implementation of the INTERGROWTH-21st international standards for preterm postnatal growth and evidence-based feeding recommendations based on human milk.

Within this project we aim to identify healthcare institutions that provide care to preterm babies and infants and establish an online community of health professionals who are able to apply and widely disseminate the feeding protocol and monitor the postnatal growth of preterm infants using the INTERGROWTH-21st standards.

Specifically, we plan to implement the INTERGROWTH-21st growth monitoring and feeding protocols in leading neonatal units around the world and, ultimately, gain high-level health policy support for these practices. The combination of using recommended feeding practices and international standards to monitor postnatal growth and development of preterm infants should help to: a) avoid nutritional patterns that may be associated with childhood overweight and obesity, and b) improve the growth, development and survival of preterm infants.

INTERGROWTH-21st Project

The International Fetal and Newborn Growth Consortium for the 21st Century, (INTERGROWTH-21st), is a global, multidisciplinary network of more than 300 researchers and clinicians from 27 institutions in 18 countries worldwide coordinated from the University of Oxford. It is dedicated to improving perinatal health globally and committed to identifying fetal and newborn growth restriction, hence reducing the millions of preventable deaths that occur during the first 1000 days of life as a result of preterm birth or poor intrauterine growth.

In order to meet this goal, international growth standards to measure and improve maternal and newborn clinical care, and compare outcomes across populations are needed. Such standards exist to monitor the growth of infants and children. They are the WHO Child Growth Standards, and their release in 2006 was a landmark achievement. These scientifically based standards are now used worldwide.

However, the fetal and newborn counterpart has been missing, which led to the implementation of the INTERGROWTH-21st Project. The aim was to extend the WHO Child Growth Standards into the fetal and neonatal period, providing tools for continuity of care from conception to 5 years of age.

The INTERGROWTH-21st Consortium implemented population-based studies using standardized methods, and clinical research protocols. It gathered a rich body of data on health, growth and nutrition from pregnancy to early infancy from close to 60,000 women and newborns across five continents, making the INTERGROWTH-21st Project the largest collaborative venture in the field of perinatal health research to date.

The resulting data provide unique insights into growth and development for the 21st century. The findings also provide new ways of classifying preterm and small for gestational age newborns. In addition, the INTERGROWTH-21st Consortium have produced a new international equation for estimating gestational age by ultrasound early in pregnancy based on the first international crown-rump length standards, and have developed the resources necessary for enabling the adoption and scale-up of these tools at all levels of the health care system.

Preterm infant feeding and growth monitoring: Implementation of the INTERGROWTH-21st protocol, interactive e-Learning course

About the development of this course

The development of this course was motivated by the commitment of the INTERGROWTH-21st Consortium to improve perinatal health globally. This training course is a practical interactive package targeted at health professionals caring for preterm infants that promotes the INTERGROWTH-21st feeding protocol and the new standards.

Large-scale dissemination of the course is implemented with the support of the INTERGROWTH-21st Consortium, the Global Health Network (TGHN), George Institute for Global Health (GIGH), Save the Children, and Maternal Health Taskforce (MHTF) to reach a global population of doctors, nurses and other health professionals caring for preterm infants, plus policymakers.

Course contents

Module 1

Background on preterm birth

Module 2

Gastro-Intestinal Development in Preterm Infants

Module 3

Feeding recommendations for the routine care of preterm infants

 

Final Quiz

Course Certificate - requires a minimum of 80% correct answers

Course References

Frequently Asked Questions (FAQs) during the implementation of the Preterm Postnatal Growth Standards

Partners:

Maternal Health Task Force (MHTF), Harvard School of Public Health

Oxford Maternal & Perinatal Health Institute (OMPHI)

The Global Health Network (TGHN)

Geneva Foundation for Medical Education and Research (GFMER)

Advisory group:

José Villar, MD, MPH, MSc, FRCOG
Professor of Perinatal Medicine, Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, UK

Ana Langer, MD
Director, Women and Health Initiative. Director, Maternal Health Task Force. Professor of the Practice of Public Health, Harvard T. H. Chan School of Public Health, US

Aldo Campana, MD
Emeritus Professor, Obstetrics and Gynaecology, Faculty of Medicine, University of Geneva. Director, Geneva Foundation for Medical Education and Research, Switzerland

Editorial team:

Bonventure Ameyo Masakhwe, MD
Geneva Foundation for Medical Education and Research, Kenya

Karim Abawi, MD, MSc, MPH
Project Manager, Education & Research, Geneva Foundation for Medical Education and Research, Switzerland

Leila Cheikh Ismail, PhD
Project Leader INTERGROWTH-21st, University of Oxford, Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Headington Oxford, OX3 9DU, UK

Raqibat Idris, MBBS, MPH
Technical Officer, Geneva Foundation for Medical Education and Research, Switzerland

Aris Papageorgiou, MD, MRCOG
Associate Professor of Fetal Medicine, Nuffield Department of Obstetrics & Gynaecology, Clinical Research Director, OMPHI, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK

Francesca Giuliani, MD
Consultant Paediatrician, Ospedale Infantile Regina Margherita-Sant’ Anna, Città della Salute e della Scienza di Torino, Turin, Italy

Ann Lambert, PhD
Project Administrator INTERGROWTH-21st, University of Oxford, Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Headington, Oxford, OX3 9DU,

Application developers:

Liam Boggs
Training Manager, The Global Health Network, Centre for Tropical Medicine & Global Health, University of Oxford, UK

Felicity Baka
Training Assistant, The Global Health Network, Centre for Tropical Medicine & Global Health, University of Oxford, UK

Laxchiman Gurung
Administrative Assistant, The Global Health Network, Centre for Tropical Medicine & Global Health, University of Oxford, UK

Funding:

The INTERPRACTICE-21st  Project is funded by the Family Larsson-Rosenquist Foundation