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

Abstract

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.

Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National Hospital in Dar-es-salaam, Tanzania: a prospective cohort study

“…Several studies have reported similar findings of high proportion in poor weight gain among preterm [3,12,[15][16][17], contrarily other studies have found marked advancement in the growth of the preterm [18,19]. The difference observed across these studies in comparison to this study could be explained by the differences in characteristics of study participants, the different existing feeding protocols and the support available for supervising feeding of these vulnerable neonates.…”

“…Delaying feeding (more than 48 h) is among the factors that have been reported in this study to increase the risk of poor weight gain. The association between late initiation of enteral feeding and poor growth in preterm was similarly observed in these studies [3,17,19,23]. Additionally, other study showed that less aggressive progression of enteral feeds might increase the incidence of poor growth failure of both early and late preterm.…”

Patterns of Postnatal Weight Gain and its predictors among Preterm Very Low Birth Weight Neonates Born in Bahir-Dar Public Hospitals Retrospective Follow up Study, 2022

“…Initiation of the rst feed on the rst day of life had 3 times more adequate postnatal weight gain than those whose initiation was on the second day and beyond among the preterm VLBW neonates. This nding has been demonstrated in other studies conducted in Iran and Tanzania (9,13,14),which showed that early initiation of the enteral feeds was associated with faster growth rates compared to those who were delayed. This is due to early initiation of feeding being associated with early maturation of the intestinal villi and tolerance of the enteral feeds.…”

“…Furthermore, the average weight gain observed was below the preterm weight gain target (≥ 15 g/kg/day), which is estimated to corresponding normal fetal growth rates in third trimester pregnancy (12)(13)(14) and the average postnatal weight gain in this study was 11.4 ± 3.8 g/kg/d which is lower than expected weight gain (15/g/kg/d) and study done in India (16.24 ± 2.37 g/kg/d) (12,15) and higher than study done in Nigeria (8.2 ± 3.3 g/kg/day)(16). According to the ndings of a multicenter international study "Intergrowth-21st fetal growth standards", difference in postnatal weight gain across different populations is mostly dependent on environmental, nutritional, and socioeconomic factors (17).…”

The Effect of Dual Strain Probiotic on the Growth and Feeding Intolerance in Premature Neonates of Kabul city: A Randomized Clinical Trial

“…19 On the second week after birth, preterm babies have the slowest mean growth velocity of 6.8 g/kg/day. 20 Such slow weight gaining is more challenging for the neonatal care in our country because of less advanced neonatal units. Enhancing preterm neonatal growth may decrease complications, hospital stays and mortality, and highly required for the better neonatal care.…”