Mortality Among Low Birth Weight Neonates on Parenteral Feeding: A Prospective Follow-Up Study

Abstract

Background

Low birth weight (LBW) neonates face a significantly higher risk of complications and mortality compared to those with normal birth weight. This risk is particularly pronounced in low-income countries, where access to quality health care and adequate nutrition is limited. However, there is insufficient data on mortality for LBW neonates while receiving parenteral feedings. Therefore, this study was aimed to investigate the incidence and determinants of mortality among admitted LBW neonates receiving parenteral feeding at Neonatal Intensive Care Units (NICUs) in selected hospitals in Addis Ababa.

Methods

A prospective follow-up study was conducted in selected hospitals’ NICU from March to June 2022. Data were collected using a structured questionnaire and checklist, and analyzed using STATA software. The assumption for survival analysis was assessed using Kaplan–Meier survival curves and a global test. Bi-variable and multivariable Cox regression analyses were performed to identify determinants of mortality. A p-value of less than 0.05 was used to declare as a significant predictor.

Results

Two hundred eighty-nine neonates with their indexed mothers were enrolled for a total of 2242 days. During this follow-up time sixty-six neonates were died, making the incidence rate of mortality among LBW neonates 29.438 per 1000 person-day. Birth weight less than 1000 grams (AHR: 9.539; 95% CI: 2.272, 40.038), admission Apgar score of three or less (AHR: 5.894 95% CI: 1.320, 26.315), edematous malnutrition (AHR: 3.389; 95% CI: 1.355, 8.474) and not initiated trophic feeding (AHR: 7.324; 95% CI: 3.453, 15.532) were identified as a significant predictors for neonatal mortality.

Conclusion

This study revealed a high incidence of mortality among low birth weight (LBW) neonates who received parenteral feeding. Furthermore, factors such as birth weight, trophic feeding initiation, low Apgar score, and edematous malnutrition were identified as predictors for mortality among LBW neonates who received enteral feeding. Therefore, future studies should prioritize optimizing enteral feeding practices and enhancing the quality of care provided to LBW neonates.

Keywords:

• neonatal mortality
• low birth weight
• parenteral feeding
• neonatal feeding
• survival status

Abbreviations

AHR, adjusted hazard ratio; CHR, crude hazard ratio; CI, confidence interval; WHO, World Health Organization; LBW, Low Birth Weight; SSA, Sub-Sahara African Countries; KMC, kangaroo mother care; ANC, Antenatal care; NICU, neonatal intensive care unit.

Ethics Approval and Consent to Participate

Approval to carry out this study was received from Ethical review board of Addis Ababa University. Written informed consent was also obtained from all mothers of the included neonates, and confidentiality of the collected data were assured throughout the study. Moreover, this study complies with the declaration of Helsinki and related documents.

Data Sharing Statement

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request [email protected].

Acknowledgment

We express our gratitude to all participants and data collectors who took part in this study.

Disclosure

The authors declared that there is no conflict of interest related to the conducting or publication of this research.

Additional information

Funding

No fund was received for this study.