Intrauterine growth and postnatal nutritional status of Ethiopian preterm infants: a prospective cohort study

Gidi, Netsanet W. (2021): Intrauterine growth and postnatal nutritional status of Ethiopian preterm infants: a prospective cohort study. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background: Severe nutritional deficit experienced in early life results in growth restriction and long term metabolic and neurodevelopmental complications. Establishing enteral feeding is often difficult in neonatal intensive care units, and recent advances in nutritional support are unavailable in low income countries. Method: This was a hospital-based multi-center descriptive study, under SIP project (Study of causes of illness and death of preterm infants in Ethiopia). Neonatal outcomes of 1336, 1:1 matched, singleton small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants were compared. The incidence and associated factors of extrauterine growth restriction (EUGR) was assessed in 436 preterm infants at the time of discharge from the hospital. Result: The SGA infants had increased risk of hypoglycemia (OR and 95% CI) 1.6 (1.2-2.0), necrotizing enterocolitis (NEC) 2.3 (1.2-4.1), polycythemia 3.0 (1.6-5.4), late onset neonatal sepsis (LOS) 3.6 (1.1-10.9)) and prolonged hospitalization 2.9 (2.0-4.2), whereas, the incidence of respiratory distress syndrome (RDS), apnea and mortality were not different in the SGA and AGA groups. Over all 86.2% of the infants had EUGR, those who were SGA, VLBW, and stayed in the hospital over 21 days had increased risk of EUGR (p-value <0.01). SGA infants had the highest risk of developing EUGR at the time of discharge compared to non-SGA (OR (95% CI) = 15.2 (4.6-50.1). Conclusion: The high incidence of EUGR observed in this study indicates that the nutritional support of the preterm infants was inadequate. SGA preterm infants are at particular risk for neonatal morbidities such as failure to thrive, hypoglycemia, NEC, LOS and polycythemia. Guidelines on preterm infants feeding in Ethiopia need to be updated and nutritional practices in the NICUs have to be improved. Further studies are needed to explore better approaches on nutritional support of sick preterm infants in low income settings.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: EUGR, SGA, VLBW, preterm nutrition, IUGR, neonatal mortality
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 14. April 2021
• 1. Bericht­erstatter:in: Genzel-Boroviczény, Orsolya