Neonatal health factors affecting optimal weight gain among preterm neonates in Murang’a county, Kenya

Abstract

Preterm neonates need to achieve optimum weight gain, precisely 15 g/kg of body weight per day, to enhance their chances of survival and development. However, they develop various complications as newborns, including Respiratory Distress Syndrome, Neonatal jaundice, and Chromosomal disorders that affect their growth. To develop mitigation measures, this research aimed to investigate the neonatal health factors that affect optimal weight gain among preterm neonates in Murang’a County Referral Hospital, Kenya.  A retrospective cohort study was employed. The study included preterm neonates admitted to the newborn unit (NBU) between February and July 2024 (107 preterm neonates). Medical records were used to extract data on neonatal characteristics, morbidities, medical interventions, and complications. Weight gain velocity was used as a growth outcome and classified as optimal (≥15 g/kg/day) or suboptimal (<15 g/kg/day). Multivariable logistic regression models were used to determine predictors of weight gain, reported as crude odds ratios (CORs) and adjusted odds ratios (AORs) with 95% confidence intervals (CIs). 48 (44.9%) of the neonates in this study had an optimal weight gain, while 59 (55.1%) had suboptimal weight gain. This study had a significant correlation between low birth weight and suboptimal growth rate. The study also identified that medical complications, respiratory distress syndrome, jaundice, and sepsis had a significant correlation to achieving optimal weight gain. Other factors investigated in this study – CPAP, oxygen, phototherapy, antibiotic use, steroid use, and diuretic use – did not affect weight gain.  Proper management of LBW, sepsis, jaundice, RDS, and medical complications associated with prematurity should be prioritized to ensure optimal weight gain among preterm neonates. Adequate resources and enhanced medical protocols are crucial and key to better outcomes in this population.