Fenton 2025 Third generation Preterm Growth Charts
The Fenton Growth Charts are designed for growth monitoring of preterm infants with birth gestational age less than 37 weeks
The Fenton growth chart for preterm infants has been revised to accommodate the World Health Organization Growth Standard and reflect actual age instead of completed weeks, in order to improve preterm infant growth monitoring.
BMC Pediatrics
Editor
The Fenton charts are endorsed by the French, Portuguese, Colombian and Turkish Pediatric Societies, the American Academy of Pediatrics, the Chinese Neonatal Network, the Ecuador Ministry of Public Health, the French Society of Neonatology, the Spanish Society of Gastroenterology and Paediatric Nutrition and the Merck Manual.
Systematic Reviews
Fenton TR, Elmrayed S, Alshaikh BN. Fenton third-generation Growth Charts of preterm infants without abnormal fetal growth: A systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2025.
https://doi.org/10.1111/ppe.70035.
https://pubmed.ncbi.nlm.nih.gov/40534585/
A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. Fenton, Tanis R & Kim, Jae H. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics.2013, 13:59 http://www.biomedcentral.com/1471-2431/13/59
Growth Chart Validation Study
Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. Fenton TR, Nasser R, Eliasziw M, Kim JH, Bilan D, Sauve R. Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr. 2013;13(1):92. http://www.biomedcentral.com/1471-2431/13/92
Assign gestational age size at birth
People use the Fenton preterm infant growth charts for 2 purposes: i) preterm infant growth monitoring and ii) to assign size-at-birth for gestational age (small, large and appropriate). The Fenton growth charts (designed for preterm infant growth monitoring for infants born <38 weeks) can be used to assign size-at-birth for gestational ages 22 to 37 weeks, but ideally not for gestational ages at 38 weeks or beyond. Due to numerous requests, we have produced the 2025 15-country meta-analysis specifically for size-at-birth assessments for infants born from 22-42 weeks. To assign size for gestational age at birth for 38 weeks or beyond, download our 2025 15-country-meta-analysis sex-specific percentile cutoffs and/or calculator below.
The size-at-birth numerical values differ from the growth charts, which have a rescaled x-axis to exact gestational age (weeks and days) to support daily plotting (as described in our development paper: https://doi.org/10.1111/ppe.70035). Both the size-at-birth calculator and cutoffs use completed gestational week, based on tradition.
The 2013 6-country meta-analysis sex-specific percentiles are also available. They are also not the same as the growth charts, so they are also not appropriate to use for growth monitoring.
Global Usage
The charts are being used in the following countries: Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Colombia, Costa Rica, Croatia, Ecuador, Estonia, France, Germany, Greece, India, Indonesia, Iran, Ireland, Israel, Italy, Korea, Kuwait, Mexico, New Zealand, Norway, Peru, Poland, Portugal, Romania, Russia, Saudi Arabia, Singapore, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, the Netherlands, the UK, the UAE and the USA.