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

Figures & data

Table 1 Characteristics of the Preterm Neonates (N=178)

Characteristic	N	%
Sex
Male	95	53.4
Female	83	46.6
Birth weight (grams)
>1500	84	47.2
1000–1500	79	44.4
<1000	15	8.4
Mean (SD)	1512.36 (32.6)
Gestation age (weeks)
33–36	86	48.3
28–32	92	51.7
Mean (SD)	31.91 (2.0)
Size for GA
AGA	151	84.8
SGA	27	15.2
Birth type
Single tone	152	85.4
Multiple	26	14.6
First feed (hours)
<48	110	61.8
≥48	68	38.2
Mean (SD)	58.2(4.8)

Abbreviations: AGA, appropriate for gestation age; GA, gestation age; SGA, small for gestation age.

Figure 1 Number of patients enrolled and followed up to completion of the study (N=178).

Table 2 Characteristics of the Mothers (N=178)

Characteristic	N	%
Age
15–19	28	15.7
20–29	106	59.6
≥ 30	44	24.7
Mean (SD)	25 (2.9)
Marital status
Single	54	30.3
Married	86	48.3
Cohabiting	38	21.4
Height (cm)
150+	51	28.7
<150	127	71.3
Mean (SD)	146 (4.3)
Level of education
Secondary/above	56	31.5
Primary/below	122	68.5
Occupation
Employed	27	15.2
Unemployed	151	84.8
Number of antenatal visits
≥4	82	46.1
<4	96	53.9
Mean (SD)	2.5(3.4)
HIV status
Negative	174	97.8
Positive	4	2.2
Illness in pregnancy
No	142	79.8
Yes	36	20.2

Abbreviations: HIV, human immunodeficiency virus; SD, standard deviation.

Figure 2 Weekly weight growth velocity for the four postnatal weeks of the preterm babies. Second week growth velocity was half of the intrauterine velocity of 15 g/kg/day, an international standard recommended.⁴

Table 3 Preterm Growth Velocity Variations Through Different Neonatal Characteristics (N=178)

Variables	Mean (SD) (g/kg/day)	95%CI		P-value
Sex
Male	13.2 (5.0)	12.2021	14.2736	0.149^Table Footnotea
Female	12.1 (5.3)	10.9625	13.0621
Birth weight (grams)
>1500	13.2 (4.8)	12.4897	14.5721	0.108^Table Footnoteb
1000–1500	12.8 (3.4)	10.9581	14.7248
>1000	11.8 (5.7)	10.5339	13.1042
Gestation age (Weeks)
(33–34)	13.9 (5.3)	11.8142	14.0697	0.571^Table Footnotea
(28–32)	12.5 (5.1)	11.4356	13.5625
Size for GA
SGA	12.3 (5.3)	10.1733	14.3941	0.642^Table Footnotea
AGA	12.8 (5.2)	11.9580	13.6216
First feed (Hrs.)
< 48	14.3 (4.8)	13.3444	15.1697	<0.0001^Table Footnotea
≥ 48	10.2 (4.8)	9.0582	11.3724
Birth type
Single tone	12.9 (5.3)	11.0489	13.7545	0.242^Table Footnotea
Multiple	11.6 (4.2)	9.9026	13.3178

Notes:

a T-test.

b ANOVA test

Abbreviations: AGA, appropriate for gestation age; GA, gestation age; SGA, small for gestation age.

Table 4 Preterm Growth Velocity Variations Through Different Maternal Characteristics (N=178)

Variables	Mean (SD) (g/Kg/Day)	95% CI		P-value
Age
15–19	13.7(5.4)	11.5645	15.7879	0.564^Table Footnoteb
20–29	12.6(5.4)	11.5189	13.5964
30+	12.5(4.5)	11.1040	13.8448
Height (cm)
150+	12.1(5.2)	10.5825	13.5276	0.285^Table Footnotea
<150	12.0(5.2)	11.0707	13.8839
Level of education
Secondary/above	14.2(5.0)	12.9044	15.5740	0.007^Table Footnotea
Primary/below	12.0(5.2)	11.0903	12.9347
Occupation
Employed	14.6(5.1)	12.6144	16.6170	0.038^Table Footnotea
Unemployed	12.4(5.2)	11.5446	13.2010
HIV status
Positive	12.7(5.2)	11.9093	10.2730	0.711^Table Footnotea
Negative	13.7(3.3)	11.5858	15.9446
Illness in pregnancy
No	13.7(4.9)	12.8784	14.5073	<0.0001^Table Footnotea
Yes	8.8(4.4)	7.3485	10.3477
Antenatal steroids
No	13.6(5.2)	12.6470	14.6231	0.003^Table Footnotea
Yes	11.3(4.89)	10.1224	12.4586

Notes:

a t-test

b ANOVA test

Abbreviation: HIV, human immunodeficiency virus.

Table 5 Preterm Growth Velocity Variations Through Different Postnatal Diseases (N=178)

Variables	Mean (SD) (g/kg/day)	(95%CI)		P-value
RDS
No	12.3	10.3	13.5
Yes	7.6	4.86	10.0	0.001^Table Footnotea
Sepsis
No	12.5	11.2	13.7
Yes	8.9	6.4	11.4	0.005^Table Footnotea
CHD
No	11.5	10.9	12.7
Yes	10.1	8.3	12.6	0.569^Table Footnotea

Note:

a t-test.

Abbreviations: CHD, congenital heart diseases; RDS, respiratory distress syndrome.

Table 6 Logistic Regression Analysis for Predictors of Poor Growth Velocity Among Preterm Babies (N=178)

Variables	COR	(95%CI)	P-value	AOR	(95%CI)	P-value
Illness in pregnancy
No	1			1
Yes	4.27	1.82–10.00	0.001	6.94	2.07–13.28	0.001
Antenatal steroids
No	1			1
Yes	2.11	1.14–3.92	0.034	2.61	1.04–6.59	0.002
Sex of the baby
Male	1			1
Female	1.91	0.29–0.95	0.034	2.34	1.09–5.02	0.029
Birth weight (grams)
>1500	1			1
≤1500	1.24	0.69–2.24	0.468	1.33	1.13–1.86	0.021
Gestation age (weeks)
33–36	1			1
28–32	1.25	0.69–2.25	0.462	1.08	0.45–2.60	0.868
Size for GA
AGA	1			1
SGA	1.18	0.52–2.68	0.690	0.58	0.21–1.61	0.295
First feed (hours)
<48	1			1
≥48	3.60	1.89–6.87	<0.001	8.44	2.90–14.54	<0.001
Birth type
Singleton	1			1
Multiple	1.60	0.68–3.75	0.279	1.72	0.50–5.93	0.388
RDS
No	1			1
Yes	2.27	1.03–5.00	0.042	2.32	(0.73–7.38)	0.156
Sepsis
No	1			1
Yes	2.32	1.19–4.53	0.014	1.93	(0.82–4.58)	0.135
CHD
No	1			1
Yes	1.13	0.33–3.84	0.845	0.52	(0.10–2.72)	0.437

Abbreviations: AGA, appropriate for gestation age; AOR, adjusted odds ratio; CHD, congenital heart diseases; COR, crude odds ratio; GA, gestation age; RDS, respiratory distress syndrome; SGA, small for gestation age.

De Curtis M, Rigo J. The nutrition of preterm infants. Early Hum Dev. 2012;88(Suppl 1):S5–7. doi:10.1016/j.earlhumdev.2011.12.020

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