3Sep

GA, PMA, PCA, Chronological Age, Corrected Age – Using the Correct Terminology in the NICU

By Sue Ludwig

What term do most units use when addressing age of infants – Post conceptional age (PCA), post menstrual age (PMA), corrected gestational age (CGA) and why one over the other?

TOW_9-3-14aAcronym soup anyone?

This question was asked during our August Inner Circle Mentoring Call (ICMC). And since it’s been asked in various ways at other times I thought I’d address it here as well.

The way I answered it on the ICMC is based on the information below. I came across the paper, by AAP’s Committee on Fetus and Newborn, years ago while writing a professional article. I wanted to be sure I was using the correct terminology since I saw many different terms being used interchangeably in NICUs.

I believe you’ll find it helpful.

While the summary is quoted here, you can also access the full article on the web (see below). For NANT Members – this link is also posted in the Member Area next to the recording of the ICMC.

The following information is quoted from:

Age Terminology During the Perinatal Period.” Pediatrics 114.5 (2004): 1362-364. Web.

“Standardized terminology should be used when defining ages and comparing outcomes of fetuses and newborns. The recommended terms are:

Gestational age (completed weeks): time elapsed between the first day of the last menstrual period and the day of delivery. If pregnancy was achieved using assisted reproductive technology, gestational age is calculated by adding 2 weeks to the conceptional age.

Chronological age (days, weeks, months, or years): time elapsed from birth.

Postmenstrual age (weeks): gestational age plus chronological age.

Corrected age (weeks or months): chronological age reduced by the number of weeks born before 40 weeks of gestation; the term should be used only for children up to 3 years of age who were born preterm.

**During the perinatal period neonatal hospital stay, “postmenstrual age” is preferred to describe the age of preterm infants. After the perinatal period, “corrected age” is the preferred term.

“Conceptional age,” “postconceptional age,” “conceptual age,” and “postconceptual age” should not be used in clinical pediatrics.

Publications reporting fetal and neonatal outcomes should clearly describe methods used to determine gestational age.”

http://pediatrics.aappublications.org/content/114/5/1362.full.html

And here’s the thing: if we’re confused about this terminology, what do NICU parents think as we unknowingly use different terms?  Creating a simple guide or poster for this language would be helpful for staff and parents alike.

Also, as neonatal therapists, it’s up to us to explain how this terminology applies to developmental milestones. For example, an infant born at 24 weeks GA, who is now 40 weeks PMA, is not developmentally ready to attempt cereal or baby food. (Even though he’s chronologically 4 months old.) And of course we know that this doesn’t mean he’s lagging behind!

But not everyone knows. Not everyone understands the developmental portion of this equation unless we bring it to light.

Food for thought.

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