Poor weight gain and its predictors among preterm neonates admitted at Muhimbili National hospital in Dar-es-salaam, Tanzania from September 2018 to February 2019

Abstract

Background: Preterm delivery is among the major public health problems worldwide and the leading cause of morbidity and mortality among neonates. Postnatal poor weight gain, which can contribute to mortality, can be influenced by feeding practices, medical complications and quality of care that is provided to these high-risk neonates. This study aimed to investigate the proportion and predictors of poor weight gain among preterm neonates at Muhimbili National Hospital (MNH), from September 2018 to February 2019.Methods: A hospital-based prospective cohort study involving preterm neonates with Gestation age (GA) <37 weeks receiving care at MNH. Eligible preterm, were consecutively recruited at admission and followed up until discharge, death or end of neonatal period. Poor weight gain was defined as weight gain less than 15g per kg per day. The risk factors associated with poor weight gain were evaluated. Predictors of poor weight gain were evaluated using a multivariate analysis. Results were considered statistically significant if P -value was ˂ 0.05 and 95% confidence interval (CI) did not include 1 Results: A total of 227 preterm neonates < 37 weeks GA, with male to female ratio of 1:1.2 were enrolled in the study. The overall proportion of preterm with poor weight gain was 86.8% (197/227). Proportion of poor weight gain among the early and late preterm babies, were 88.5% (100/113) and 85.1% (97/114) respectively. Predictors of poor weight gain were low level of maternal education (AOR=2.58; 95%Cl: 1.02-6.53), cup feeding as the initial method of feeding (AOR=8.65; 95%Cl: 1.59-16.24) and delayed initiation of the first feed (AOR=10.06; 95%Cl: 4.14-24.43). A previous history of preterm delivery was protective against poor weight gain (AOR=0.33; 95% Cl: 0.11-0.79). Conclusion and recommendation: Poor weight gain was a significant problem among preterm receiving care at MNH. This can be addressed by emphasizing on early initiation of feed and tube feeding for neonates who are not able to breastfeed. Health education and counselling to mothers focusing on feeding practices as well as close supervision of feeding especially for mothers experiencing difficulties in feeding their preterm will potentially minimize risk of growth failure.

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.…”

“…The sample size was calculated using Open Epi-info Version 7.2.5 considering 95% con dence interval and 80% power. The larger sample size(213) was achieved by using the double population proportion formula considering the percent of adequate weight gain by VLBW infants whose rst feed is within 24 hours(38.3%),RR = 2.2 and percent of adequate weight gain by VLBW infants whose rst feed is longer than 24 hours(17.4) from a study conducted in Tanzania (9). Systematic random sampling technique was used to select cards of preterm VLBW neonates from each hospital.…”

“…A structured questionnaire adapted from different literatures to collect data from cards of preterm neonates was used (4,6,9,10). The data collection tools have four main parts: -the socio-demographic characteristics, feeding practice of the neonate, obstetric characteristics and comorbid condition of the neonate.…”