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