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Abstrak :
Latar belakang: Sekitar 10,6% persalinan di seluruh dunia adalah persalinan prematur. Pemantauan pertumbuhan yang adekuat dalam perawatan bayi prematur penting untuk mencegah kelebihan atau kekurangan asupan nutrisi, yang saat ini dapat dilakukan menggunakan kurva Fenton 2013 atau kurva INTERGROWTH-21st. Karena perbedaan metodologi dan populasi yang terlibat pada proses penyusunan kedua kurva, hasil yang didapatkan dapat berbeda. Oleh karena itu, dibutuhkan penelitian untuk membandingkan penggunaan kedua kurva tersebut pada populasi bayi prematur di Indonesia. Metode: Penelitian kohort prospektif ini melibatkan subjek bayi prematur dengan usia gestasi lahir 28–36 minggu di RSUPN Dr. Cipto Mangunkusumo selama Juni–September 2022. Seluruh subjek dipantau dengan kurva Fenton dan kurva INTERGROWTH-21st selama 2 minggu, dan dievaluasi perbedaan persentil berat badan, panjang badan, dan lingkar kepala, proporsi SGA, AGA, dan LGA, dan perbandingan proporsi subjek dengan EUGR pada usia 2 minggu. Hasil: Dari 131 subjek yang memenuhi kriteria inklusi, didapatkan persentil berat badan, panjang badan, dan lingkar kepala lebih tinggi secara bermakna pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Sebanyak 17 dari 36 (47,2%) subjek yang tergolong SGA berdasarkan kurva Fenton pada saat lahir didapatkan lebih sesuai dengan AGA berdasarkan kurva INTERGROWTH-21st, dan 30 dari 89 (33,7%) subjek yang tergolong AGA berdasarkan kurva Fenton saat lahir didapatkan lebih sesuai dengan LGA berdasarkan kurva INTERGROWTH-21st. Subjek yang lahir sesuai AGA tetapi mengalami EUGR pada usia 2 minggu didapatkan lebih tinggi secara bermakna pada kurva Fenton (14,7%) dibandingkan kurva INTERGROWTH-21st (8,9%, p <0,001). Kesimpulan: Insidens SGA didapatkan lebih tinggi pada kurva Fenton dibandingkan INTERGROWTH-21st, sedangkan LGA lebih tinggi pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Pada usia kronologis 2 minggu, insidens subjek dengan EUGR lebih tinggi secara bermakna dengan kurva Fenton dibandingkan kurva INTERGROWTH-21st. ......Background: Approximately 10.6% of all deliveries worldwide are premature. Adequate growth monitoring is essential in the care of preterm infants to prevent excessive or undernutrition, which can currently be performed using the Fenton 2013 curve or the INTERGROWTH-21st curve. Due to differences in the methods and study population involved in the development of these two curves, there is a high possibility of obtaining different results. Therefore, a study is warranted to compare the two curves in the Indonesian premature infant population. Methods: This prospective cohort study involves premature neonates with gestational age of 28–36 weeks born in Cipto Mangunkusumo Hospital during June–September 2022. The growth of all subjects were plotted on the Fenton and INTERGROWTH-21st curves for 2 weeks, and differences in weight, height, and head circumference percentiles, proportion of SGA, AGA, and LGA, and proportion of infants with weight below the 10th percentile between the two curves at 2 weeks were also compared. Results: Among 131 subjects meeting the inclusion criteria, the weight, height, and head circumference percentiles were significantly higher on the INTERGROWTH-21st curve compared to the Fenton curve. As many as 17 of 36 (47.2%) subjects classified as SGA on the Fenton curve were AGA on the INTERGROWTH-21st curve, and 30 of 89 (33.7%) subjects classified as AGA on the Fenton curve were LGA on the INTERGROWTH-21st curve. The prevalence of infants without SGA at birth but classified as EUGR at 2 weeks was significantly higher on the Fenton curve (14.7%) than the INTERGROWTH-21st curve (8.9%, p <0.001). Conclusion: The incidence of SGA was significantly higher with the Fenton curve, whereas LGA was significantly higher with the INTERGROWTH-21st curve. At 2 weeks, the proportion of subjects with EUGR was significantly higher with the Fenton curve compared to the INTERGROWTH-21st curve.

Abstrak :
Latar belakang: Asuhan nutrisi optimal untuk bayi prematur bertujuan mengoptimalkan tumbuh kembang dan peningkatkan kualitas hidup bayi prematur. Asuhan nutrisi berupa penilaian masalah nutrisi, menentukan kebutuhan nutrisi, dan pemantauan pertumbuhan membutuhkan kurva pertumbuhan. Saat ini tidak ada kurva pertumbuhan standar untuk bayi prematur. Tujuan: Membandingkan laju pertumbuhan setiap minggu hingga maksimal usia 37 minggu pada bayi prematur yang diberikan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dan kurva Fenton, serta mengetahui hubungan antara sepsis, respiratory distress syndrome, riwayat hambatan laju pertumbuhan intrauterin dengan laju pertumbuhan berat badan . Metode: Pnelitian ini adalah uji klinis ajak tersamar ganda pada 93 bayi prematur usia gestasi 33-36 minggu. Perhitungan kebutuhan nutrisi dan pemantauan asupan dilakukan setiap hari serta pemantauan antropometri berupa berat badan, panjang badan, dan lingkar kepala dilakukan minimal satu kali dalam seminggu. Analisis uji-t dilakukan pada sebaran data normal Hasil: Pada bayi prematur yang diberikan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dan kurva Fenton tidak berbeda bermakna dalam hal laju kenaikan berat badan, panjang badan, dan lingkar kepala setiap minggu hingga maksimal usia 37 minggu. Pemberian nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dibandingkan menggunakan kurva Fenton memberikan hasil lebih banyak bayi prematur yang mencapai berat badan lahir dalam waktu kurang dari 7 hari (33% vs 19%) dan lebih banyak bayi prematur yang tumbuh liniear sesuai dengan trajektori pertumbuhan yang harus dicapai, dengan indeks berat badan 39% vs 20%, panjang badan 55% vs 36%, dan lingkar kepala 59% vs 48%. Riwayat hambatan pertumbuhan intrauterin memiliki hubungan bermakna dengan laju pertumbuhan berat badan pada pasien yang mendapatkan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st(p 0,003, IK 95% 2,326-10,239) Simpulan: Penggunaan kurva Intergrowth-21st lebih baik dibandingkan kurva Fenton dalam menentukan kebutuhan kalori dan pemantauan pertumbuhan bayi prematur, sehingga mencageha terjadinya hambatan laju pertumbuhan. ......Background: Nutrition implementation in premature babies goals are to optimize growth development and increase life quality. Nutritional implementation program including nutritional assessment, determine nutritional necessity or nutritional therapy, and monitor of premature babies' growth with standardized growth curve. Until recently, there is no standardize growth curve for premature baby. Objective: To compare growth velocity every week until maximum 37 weeks corrected age in premature infants who has been given nutritional implementation based on their ideal weight using Intergrowth-21 curve or Fenton curve. And, to correlate growth velocity and factors such as sepsis, respiratory distress syndrome, and intrauterine growth retardation. Methods: This is randomized double blinded clinical trial on 93 premature babies with gestational age range within 33-36 weeks. Daily nutritional intake and monitoring intake toleration were done. Anthropometric monitoring data were taken minimum every week. T-test analysis was used on normal data distribution. Results: There are no significant difference in weekly growth velocity (body weight, length, head circumference) in premature babies until 37 weeks corrected age who is given nutritional intake based on ideal body weight of Intergrowth-21st curve compare to Fenton curve. Intergrowth-21st curve shows more premature babies achieving babies' birth weight in less than 7 days (33% vs 19%) and more premature babies have linier growth according to their trajectory growth goals, with body weight index 39% vs 20%, body length 55% vs 36%, and head circumference 59% vs 48%. Intra uterine growth retardation and growth velocity has significant correlation in patients received nutrition implementation based on targeted ideal body weight according to  Intergrowth-21st curve (p 0,003, IK 95% 2,326-10,239). Conclusion: Intergrowth 21st curve has better result in determining nutritional necessity and monitoring growth of premature babies compare to Fenton curve in order to prevent slower growth velocity in premature babies.