Time to full enteral feeding and predictors among neonates birthweight between 1000 to 2000 grams admitted in NICU at northwest Amhara comprehensive specialized hospitals, Ethiopia, a retrospective follow-up study, 2022

Abstract

Abstract Introduction: early introduction of enteral feeding and rapid achievement of full enteral feeding are the ultimate goals for all low-birth-weight neonates in the nutritional care of preterm infants to increase the neonate's weight. The introduction of full enteral feeds for low-birth-weight infants is often delayed for several days due to concerns about feeding intolerance and necrotizing enterocolitis. However, time to full enteral feeding, and predictors of the neonate birth weight between 1000 to 2000 grams study are limited in Ethiopia. Objective: This study aims to assess time to full enteral feeding and predictors among neonates birth-weight between 1000 to 2000 grams admitted in Neonatal Intensive care Unit at Northwest Amhara Comprehensive Specialized Hospitals, Ethiopia, 2022. Methods: A two-year retrospective follow-up study was done from October 01 to November 31, 2022, and simple random sampling technique was used to select 615 low-birth weight neonates. Data were entered into EPi-data version 4.6.0.2 and exported to STATA version 14 statistical package software for analysis. The Kaplan–Meier and log-rank tests were used to estimate and compare the survival time. A Cox proportional hazards model was fitted. The goodness of fit test was checked by cox Snell residuals. Finally, the adjusted hazard ratio with 95% CI was computed, and variables with a P-value <0.05 were taken as significant predictors for the full feeding achievement. Result: A total of 615 neonates involved with a response rate of 95.94 %.The finding from this study revealed that 436 (70.89%) with (95% CI of 67.16 -74.35) was reached to full enteral feeding. The overall incidence of full enteral feeding was 10.16per 100 neonate-day observations were (95% CI: 9.25–11.16). The median survival time of follow-up was 8 days (IQR: 7-9). While presenting of GA<32 wks (AHR: 0.64; 95% CI: 0.50 - 0.82), SGA (AHR: 0.48; 95% CI: 0.35 - 0.65), formula and mixed feeding (AHR; 0.46: 95%CI: 0.29 - 0 .74), late tropic feeding start (AHR: 0.69:95%CI: 0.53 - 0.88) and Male (AHR: 0.70:95%CI: 0.55 - 0.90) were predictors of delay to time to full enteral feeding. Conclusion: The overall median time of full enteral feeding in this study was slightly higher. Special attention should be given to neonates born with a lower gestational age, small for gestational age, formula and mixed feeding, a late start to tropic feeding, and male neonates were predictors significant association of time to full enteral feeding.. Keywords: Full Enteral Feeding; Time; Birth Weight; NICU; Predictors; Ethiopia