Infant and Maternal Factors Affecting Nutrient Adequacy for Optimal Growth of Preterm Infants at Embu Referral Hospital, Embu County, Kenya
Obonyo, Zephaniah O.
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Feeding premature infants is a challenge to mothers whose babies are admitted to the newborn units. The emphasis in the management of preterm infants majorly concentrates on medication and fluid requirements but not on meeting the key nutrients for growth such as protein. The international guidelines on preterm infant feeding are not easily met by poor families in sub-Saharan Africa. Records from various hospitals in Kenya reveal preterm postnatal growth restrictions and poor outcomes in preterm infants both in hospitals and their subsequent life. In response to this revelation, several studies have been conducted to determine the possible causes of high growth retardation and death among preterm infants. However, the studies conducted in Kenya have not adequately addressed preterm feeding during their early life. The current study sought to fill this gap. The purpose of this study was to determine the nutrient adequate for optimal growth of preterm infants in the newborn unit at Embu Level Five Referral (ELFRH), Kenya. Moderating variables relating to maternal characteristics and preterm infant factors were also established for optimal growth of preterm infants during their stay in the hospital newborn unit at Embu Level Five Referral (ELFRH), Kenya. A longitudinal cohort study involving a sample size of 106 preterm infants admitted to the newborn unit (NBU) was used to execute the research at Embu Level Five Referral Hospital (ELFRH), Kenya. Moderating variables relating to maternal characteristics and preterm infant factors were also established for optimal growth of preterm infants during their stay in the hospital newborn unit. The infants’ baseline anthropometric measures were taken on admission and thereafter on alternate days and weekly assessments of length and head circumference were conducted till discharge to monitor their progress. Purposive sampling was used to determine the study area and a comprehensive sampling technique was used to determine the sample size. A validated questionnaire was used to collect the demographic and social-economic status data and the feeding progress of the preterm infants. Anthropometric measurements were taken daily for the weight while head circumference and the length every week. The data was analysed using means, percentages for descriptive analysis, Pearson correlation analysis for bivariate and linear regression analysis aided by the Statistical Programme for Social Sciences version 23.0 to predict the relationship between the independent and dependent variables. Data was presented in frequency and percentages. A p-value of <0.05 was used as the criterion for statistical significance. The study found a statistically significant moderate degree of positive correlation of (R= .649; P<.05) between nutrient adequacy and infant optimal growth with 42.1% variance in infant optimal growth explained by nutrient adequacy. Maternal factors as a moderator had a statistical insignificant contribution (R=.085; P>.05) while preterm infant factors as a moderator had a statistical significant contribution (R=.160; P< .05) additionally both contributed 0.7% and 2.5% respectively in preterm infant growth. The study concluded that nutrient adequacy had a significant effect on infant optimal growth. Maternal factors had no moderating effect on infant optimal growth. Further, the study concluded that preterm infant factors had a moderating effect on infant optimal growth. The study recommended that there was a need for the provision of adequate nutrients to facilitate the infant optimal growth; there was minimal need for the management of the maternal factors since it has no moderating effect on the infant optimal growth while there was a need for the management of the preterm infant factors in particularly mode of feeding since it revealed a significant moderating effect on nutrient adequacy for infant optimal growth.