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

摘要

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 north-eastern 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.