POSTNATAL GROWTH AMONG VERY LOW BIRTH WEIGHT NEONATES AT KENYATTA NATIONAL HOSPITAL (KNH), KENYA

Abstract

Background: Very Low Birth Weight (VLBW) are neonates with birth weight
between 1000 grams(g) and 1499 g. They are predominantly premature having been born before attaining 37 weeks of gestation. Their postnatal growth is associated with short term and long-term effects. Little is known about postnatal growth and enteral feeding of VLBW in Low- and Middle-Income Countries (LMICs). In Kenya, a previous study was published more than a decade ago.
Objectives: To determine the in-patient postnatal growth patterns and nutrition of VLBW new-borns at Kenyatta National Hospital (KNH), a tertiary referral hospital in Nairobi, Kenya
Methods: A six-month prospective cohort study was conducted at the KNH Newborn Unit (NBU) in 2022. Seventy-nine VLBW neonates admitted within the first 24 hours of life and surviving to day 14 were consecutively enrolled, excluding those with congenital malformations. Data on socio-demographic characteristics, anthropometric measurements, feeding practices, and comorbidities were collected using a structured tool. Analysis was performed using SPSS version 23.0. The population was described by summarizing variables into percentages and means. Postnatal growth was measured by analysing the proportion of VLBW regaining birthweight at 14 days of life and median time in days to achieving full enteral feeds of 150ml/kg /day. Statistical significance was interpreted at 95% confidence level. Growth velocities were
expressed as means or medians with standard deviations (SD) or interquartile ranges (IQR). Statistical significance was set at p ≤ 0.05

Results: By day 14 of life, 39 VLBW new-borns (49%) had regained their birth weight. The median postnatal growth rates were weight gain of 14.4 g/kg/day, length gain of 0.48 cm/week, and head circumference increase of 0.43 cm/week. The most common comorbidities observed were respiratory distress syndrome, neonatal jaundice, and neonatal sepsis. No independent factors were found to be significantly associated with regaining birth weight by day 14.
Conclusion: This study found that the feeding practices and postnatal growth rates at KNH are approaching the World Health Organization (WHO)- recommended weight gain rate of 15 g/kg/day.
Recommendation: Standard care practices and ongoing quality improvement initiatives at KNH should be maintained and strengthened to continue improving outcomes for VLBW neonates.