Postnatal Weight Gain Patterns in Preterm Very-Low-Birth-Weight Infants Born in a Tertiary Care Center in South India

Mathew, Georgie; Gupta, Vineeta; Santhanam, Sridhar; Rebekah, Grace

doi:10.1093/tropej/fmx038

Cited by 19 publications

(15 citation statements)

References 22 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Ndembo

Naburi

Kisenge

et al. 2021

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

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

Ndembo

Naburi

Kisenge

et al. 2021

Preprint

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“…The mean weight velocity in our study group of infants is 11.24 gm/kg/day, though lower as compared to Fenton charts, is consistent with the studies in Indian literature. 15,18 Since the babies recovered well and were discharged the mean positive weight velocity is encouraging. The wide range over which the weight velocity is spread is due to multiple factors, prominent amongst them being gestational age, weight <1000 gm, associated morbidities, delayed readiness for enteral feeds and non-fortification of the feeds.…”

Section: Discussionmentioning

confidence: 86%

Postnatal growth in very low birth weight babies fed on exclusive human breast milk

Bhattacharya

Dhingra

Adhikari

2021

Int J Contemp Pediatr

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Background: Ideal preterm nutrition should sustain growth which mirrors the intrauterine fetal growth rate. Human milk provides complete nutrition to term infants and has been recommended as the exclusive source of feeding till first 6 months. Concern regarding growth faltering in preterms has precluded exclusive use of human milk for nutrition. The aim of this study was to document the growth rates of preterms fed exclusive human milk from birth to discharge from hospital.Methods: This was a longitudinal cohort study in which all preterms admitted to neonatal intensive care unit (NICU) with very low birth weight (VLBW) and gestational age of ≤35 weeks were enrolled consecutively over a one-year period. Fluid, electrolyte and human milk intake was managed as per the NICU protocol. Vitamins and mineral supplements were added as per unit policy. Pre-feed weight, occipito-frontal circumference, and length was recorded at pre-determined intervals till discharge.Results: Data of 37 infants was analysed. The most common morbidity was respiratory distress (29.73%) followed by birth asphyxia. Average time to regain birth weight was 13.61 days while mean increase in weight, length and OFC was 11.24 gm/kg/day, 0.60 cm/week and 0.59 cm/week respectively. The NICU length of stay varied from 9-76 days.Conclusions: Exclusive use of human milk is reliable in achieving growth in preterm VLBW babies. Though the rate of growth is not comparable to intrauterine growth rates, nevertheless in the absence of accepted standards for postnatal growth in preterms on exclusive human milk, the results are reassuring.

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“…When mean weight was compared statistically at different time intervals among the study subjects, it was found to be statistically significant. Mathew et al in their study revealed that mean birth weight±SD was 1226.76±191 [26]. Mean time (±SD) to reach full volume feeds was 8.66±2.6 days.…”

Section: Discussionmentioning

confidence: 91%

ASSOCIATION OF THE IMPACT OF POSTNATAL NUTRITION ON THE GROWTH OF PRETERM INFANTS <34 WEEKS GESTATIONAL AGE FROM BIRTH TO DISCHARGE

FAUJDAR¹,

Singh

Yadav³

et al. 2020

Asian J Pharm Clin Res

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Objectives: The objectives of the study were to measure the actual daily amount of each nutrient (protein, glucose, and fat) energy and fluid as per current ESPGHAN guidelines for preterm infants and to analyze the role of nutrients at different gestational age on growth and weight of preterm infants. Material and Methods: An observational and prospective cohort study was conducted from January 1, 2018, to December 31, 2018. This study included all preterm infants born <34 weeks gestational age admitted in the neonatal intensive care unit during this period at Mahatma Gandhi Medical College and Hospital. A total of 120 preterm neonates were studied. Results: There were mean weight, length, and head circumference continues to rise till the study end. Mean energy at birth was also continues to rise till the end. Conclusion: In the study, proper nutritional supplement as per ESPHAGEN guidelines was used for the development of preterm infant. The study showed that there were statistically significant results with anthropometry parameters with preterm baby growth in all domains.

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Postnatal Weight Gain Patterns in Preterm Very-Low-Birth-Weight Infants Born in a Tertiary Care Center in South India

Abstract: The recommended growth velocity of 10-15 g/kg/day can be achieved using unfortified expressed breast milk, though at higher feeding volumes of 200 ml/kg/day. These centile curves can be useful for monitoring postnatal growth.

Cited by 19 publications

References 22 publications

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

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

Postnatal growth in very low birth weight babies fed on exclusive human breast milk

ASSOCIATION OF THE IMPACT OF POSTNATAL NUTRITION ON THE GROWTH OF PRETERM INFANTS <34 WEEKS GESTATIONAL AGE FROM BIRTH TO DISCHARGE

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