Early growth in preterm infants after hospital discharge in rural Kenya: longitudinal study

Abstract

IntroductionPrematurity is the single most important cause of mortality during the neonatal period. The early growth of these infants has been shown to be a predictor of their later growth and neurodevelopmental outcomes. The objective of this study was to establish the determinants of early growth in preterm infants after hospital discharge at the Kitui District Hospital, Kenya.MethodsA short longitudinal study design was adopted to execute the study. During the period of April and June 2014, all the preterm infants who were discharged from the Kitui District Hospital Newborn Unit were enrolled in the study by obtaining written informed consent from their guardians. The anthropometric measurements of these infants were taken at discharge and repeated two weeks later at the Pediatric Outpatient Clinic and the Maternal Child health Clinic. A questionnaire guided interview was held with the guardians to establish infant and maternal characteristics which influenced the infants' early growth.ResultsA total of 112 participants were enrolled for the study with 106 (94.4%) of them being available for reassessment after two weeks. Majority (72.6%) had deficit in growth by failing to attain the recommended WHO average weight gain of 15g/kg/day. Most of the mothers (63.4%) were between the ages of 20-29 years with half of them being first time mothers. Many of them (66.1%) had only attained primary education and were married (66.1%) to self-employed husbands (56%).ConclusionMost of the preterm infants at discharge were females who were born between 33 and 36 weeks gestation. Growth deficit was present in the majority and gestational age at birth was a major determinant of the early growth in these preterm infants.

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

“…Several studies have reported similar ndings of high proportion in poor weight gain among preterm (3,12,15,16), contrarily other studies have found marked advancement in the growth of the preterm (17,18). 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.…”

“…Correspondingly, these studies (3,12) reported the association of low maternal education and poor weight gain among preterm. Education always empowers mothers in all aspects and should therefore be emphasized across countries at large.…”

“…The overall proportion of preterm with poor weight gain observed in this study was high. Furthermore the observed average weight gain is below the goal for preterm weight gain (≥ 15 grams/kg/day) estimated to replicate the growth velocity of a normal foetus during third trimester of pregnancy (4,(11)(12)(13)(14). Poor weight gain was observed more among early preterm compared to late preterm infants, although this was not statistically signi cant, it may be a re ection of poor feeding as a result of feeding intolerance and also the practice in our unit during the study period of delaying initiation of feeds for at least 24 hours for this category of neonates.…”

Profile of at-risk newborns attended by nurses in outpatient follow-up clinic: a retrospective cohort study

“…Only in the last consultations, the male gender was predominant, but in relation to the weight gain, the female gender found statistical significance. Studies that indicate the profile of the attendees also vary in the predominance of males 17 or females 10 , 20 - 21 , and other studies related to growth also show that girls are the ones that gain less weight during outpatient follow-up 21 - 22 .…”

“…Regarding the data on GA and birth weight present in Table 1, this study found that the lower the gestational age and the birth weight, the more frequent and the greater the follow-up visits are. Some researches show this need for more frequent follow-up when they affirm that low birth weight and prematurity are related to an increase in morbidity and mortality, chronic conditions and readmissions 2 - 3 , 9 , 19 , 27 - 31 , as well as to the greater risk of growth deficit 3 , 21 , developmental delays and cognitive and behavioral problems 3 , 7 , 31 - 32 . In addition, growth must be closely monitored in the first year of life of patients with this profile, thus ensuring optimal brain nutrition and reducing risks of neurodevelopmental delays 19 , 33 .…”