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. 2020 Jul 24:7:2333794X20937851.
doi: 10.1177/2333794X20937851. eCollection 2020.

Preterm Nutrition and Clinical Outcomes

Netsanet Workneh Gidi  1   2 , Amha Mekasha  3 , Assaye K Nigussie  4 , Robert L Goldenberg  5 , Elizabeth M McClure  6 , Bogale Worku  7 , Gesit M Amaru  8 , Zelalem Tazu Bonger  3 , Asrat G Demtse  3 , Zemene T Kebede  9 , Matthias Siebeck  10 , Orsolya Genzel-Boroviczény  10 , Lulu M Muhe  3
Affiliations

Preterm Nutrition and Clinical Outcomes

Netsanet Workneh Gidi et al. Glob Pediatr Health. .

Abstract

Background. In low-income countries, preterm nutrition is often inadequately addressed. The aim of the study was to assess the patterns of feeding and associated clinical outcomes of preterm neonates admitted to neonatal intensive care units in Ethiopia. Method. This was a multicenter, prospective study. Infants' clinical characteristics at birth, daily monitoring of feeding history, and weight measurements were collected. An outcome assessment was completed at 28 days. Result. For this analysis, 2560 infants (53% male) were eligible. The mean (SD) gestational age was 33.1 (2.2) weeks. During the hospital stay the proportion of infants on breast milk only, preterm formula, term formula, and mixed feeding was 58%, 27.4%, 1.6%, and 34.1%, respectively. Delay in enteral feeding was associated with increased risk of death (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.33-2.78; P < .001) and (OR = 5.06, 95% CI = 3.23-7.87; P < .001) for 1 to 3 and 4 to 6 days of delay in enteral feeding, respectively, after adjusting for possible confounders. The length of delay in enteral feeding was associated with increased risk of hypoglycemia (OR = 1.2, 95% CI = 1.1-1.2; P = .005). The mortality rate was lower in hospitals providing preterm formula more often (P = .04). Half of the infants continued losing weight at the time of discharge. Conclusion. Delayed enteral feeding significantly increases the risk of mortality before discharge and hypoglycemia in preterm infants in resource-limited settings. Ensuring adequate nutritional support of preterm infants is highly needed.

Keywords: infant feeding; low- and middle-income countries; neonatal mortality; prematurity; preterm nutrition.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of recruitment of study subjects.
See this image and copyright information in PMC

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