Growth Velocity of Extremely Low Birth Weight Preterms at a Tertiary Neonatal Unit in South Africa

Lang’O, M. O.; Horn, A; Harrison, Michael

doi:10.1093/tropej/fms049

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…The calculated weekly growth velocities for the first four weeks were then arranged to give the mean growth velocity for each enrolled participant for the whole 28 days. 9…”

Section: Growth Velocity Calculationmentioning

confidence: 99%

<p>Growth Velocity and Factors Associated with Poor Postnatal Growth Rate Among Preterm Infants at KCMC: A Prospective Cohort Study</p>

Mlay¹,

Mchaile²,

Shayo³

2020

RRN

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Background: Preterm poor growth during early infancy is a major problem that can lead into adverse growth and neurodevelopmental outcomes both in the early and later stages of life, contributing to the burden of malnutrition in under-fives globally, particularly in low resource settings. The aim of this study was to determine the growth velocity in preterm infants compared with international standards of growth velocity given the nutrition practices and factors associated with poor growth rates in northeastern Tanzania. Methods: This was a prospective cohort study conducted from December 2018 to May 2019. Participants born during this period were followed-up with their weight measurements taken weekly from day one to day 28. Their weekly growth velocity was calculated using the two-point average weight model with the mean velocity for the first month extrapolated from the weekly velocities. T-test and ANOVA were used to compare the mean velocity, and logistic regression was used to analyze the association between the variables. Results: We enrolled a total of 178 participants. The mean growth velocity was 12.7 (SD=1.2) g/kg/day. There was significant difference on the mean growth velocities of those with postnatal morbidity and those who had none. Delay in the initiation of the enteral feeds for more than 48 h was associated with 8.44 higher odds of slower growth rate (95%CI: 2.90-14.54). Babies born to mothers, who had maternal illness and those whom antenatal steroids for lung maturation were administered, were having significantly higher odds 6.94 (95%CI: 2.07-13.28) and 2.61 [95%CI: 1.04-6.59) of slower growth rate compared to their counterparts. Conclusion: Given the nutritional practices in Northeastern Tanzania, our cohort showed suboptimal growth velocity compared to international standards. Early initiation of the enteral feeds could improve growth rates of the preterm babies in this low resource setting, depending on the tolerance, clinical status, and medical intervention performed in this population group.

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“…The calculated weekly growth velocities for the first four weeks were then arranged to give the mean growth velocity for each enrolled participant for the whole 28 days. 9…”

Section: Growth Velocity Calculationmentioning

confidence: 99%

<p>Growth Velocity and Factors Associated with Poor Postnatal Growth Rate Among Preterm Infants at KCMC: A Prospective Cohort Study</p>

Mlay¹,

Mchaile²,

Shayo³

2020

RRN

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“…• Subsequent weight gain occurs at the rate of 14 g/kg/day, based on South African data (Lango, Horn, & Harrison, 2013), regardless of type of milk received.…”

Section: Milk Volumementioning

confidence: 99%

Prioritising allocation of donor human breast milk amongst very low birthweight infants in middle‐income countries

Taylor

Joolay

Buckle

et al. 2018

Maternal & Child Nutrition

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The use of donor human breast milk instead of formula reduces the risk of necrotising enterocolitis in preterm infants when their mother's own milk is insufficient. Use of donor milk is limited by the cost of establishing a milk bank and a lack of donors, but the optimal rationing of limited donor milk is unclear. This paper uses an economic model to explore how a limited donor milk supply should be allocated across very low birthweight infants in South Africa considering 2 outcomes: maximising lives saved and minimising costs. We developed a probabilistic cohort Markov decision model with 10,000 infants across 4 birthweight groups. We evaluated allocation scenarios in which infants in each group could be exclusively formula‐fed or fed donor milk for 14 or 28 days and thereafter formula until death or discharge. Prioritising infants in the lowest birthweight groups would save the most lives, whereas prioritising infants in the highest birthweight groups would result in the highest cost savings. All allocation scenarios would be considered very cost‐effective in South Africa compared to the use of formula; the “worst case” was $619 per Disability Adjusted Life Year averted. There is a compelling argument to increase the supply of donor milk in middle‐income countries. Our analysis could be extended by taking a longer term perspective, using data from more than one country and exploring the use of donor milk as an adjunct to mother's own milk, rather than a pure substitute for it.

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“…Five different studies 11,[19][20][21][22] analyzed the association between LBW, VLBW and ELBW with growth and regain of body weight and length (Table 1). A longitudinal study verified that gestational age is negatively correlate with initial weight loss and growth and positively correlated with the body weight regain.…”

Section: Association Between Lbw Vlbw and Elbw With Growthmentioning

confidence: 99%

“…W = body weight in grams, D1, beginning of the time interval; Dn, end of the time interval, in days; NBW, normal birth weight. 20,22 In Uganda, from 235 LBW infants evaluated, 113 (48.1%) remained with their body weight until 21 postnatal days 11 and high body weight velocity, as an indicative of catch up growth, was found in LBW Nigerian children. 21 Association between LBW, VLBW and ELBW with neurodevelopmental outcomes Table 2 presents the two prospective studies that investigated the relationship between VLBW and ELBW with neurodevelopmental outcomes.…”

Section: Association Between Lbw Vlbw and Elbw With Growthmentioning

confidence: 99%

Low birth weight, very low birth weight and extremely low birth weight in African children aged between 0 and 5 years old: a systematic review

Tchamo

Prista

Leandro

2016

J Dev Orig Health Dis

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Low birth weight (LBW<2500), very low birth weight (VLBW<1500), extremely low birth weight (ELBW<1500) infants are at high risk for growth failure that result in delayed development. Africa is a continent that presents high rates of children born with LBW, VLBW and ELBW particularly sub-Saharan Africa. To review the existing literature that explores the repercussions of LBW, VLBW and ELBW on growth, neurodevelopmental outcome and mortality in African children aged 0-5 years old. A systematic review of peer-reviewed articles using Academic Search Complete in the following databases: PubMed, Scopus and Scholar Google. Quantitatives studies that investigated the association between LBW, VLBW, ELBW with growth, neurodevelopmental outcome and mortality, published between 2008 and 2015 were included. African studies with humans were eligible for inclusion. From the total of 2205 articles, 12 articles were identified as relevant and were subsequently reviewed in full version. Significant associations were found between LBW, VLBW and ELBW with growth, neurodevelopmental outcome and mortality. Surviving VLBW and ELBW showed increased risk of death, growth retardation and delayed neurodevelopment. Post-neonatal interventions need to be carried out in order to minimize the short-term effects of VLBW and ELBW.

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Growth Velocity of Extremely Low Birth Weight Preterms at a Tertiary Neonatal Unit in South Africa

Abstract: In our cohort of ELBW infants, growth velocity was within the range currently deemed acceptable by international consensus.

Cited by 12 publications

References 17 publications

<p>Growth Velocity and Factors Associated with Poor Postnatal Growth Rate Among Preterm Infants at KCMC: A Prospective Cohort Study</p>

<p>Growth Velocity and Factors Associated with Poor Postnatal Growth Rate Among Preterm Infants at KCMC: A Prospective Cohort Study</p>

Prioritising allocation of donor human breast milk amongst very low birthweight infants in middle‐income countries

Low birth weight, very low birth weight and extremely low birth weight in African children aged between 0 and 5 years old: a systematic review

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