Determinants of Early Growth in Premature Infants After Hospital Discharge at Kitui District Hospital

Abstract

Background: Growth restriction has been identified as one of the major complications of prematurity which eventually leads to poor outcomes in premature infants in their future. Early discharge of these infants from the hospital with their mothers as the primary caregivers puts them in to more danger since there are no established support structures and follow up care. Kitui District Hospital has markedly improved the survival of the extremely preterm infants who are the greatest risk of developing most of the complications of prematurity. The aim of this study was to establish the determinants of early growth in premature infants after hospital discharge at the Kitui District Hospital. Methodology: Longitudinal study design was used to execute this study at the Kitui District Hospital Newborn Unit, the pediatric outpatient clinic and the Maternal and Child Health clinic. Quantitative data was collected by taking the anthropometric measurements of 112 infants and interviewing the guardians at discharge. Follow up measurement of the same parameters was repeated two weeks post discharge. Data collected was coded and analyzed using a STATA version 10. Results: Most of the premature infants discharged from the hospital were females (60%) with the majority (54.5%) of them having being born between 33-37 weeks gestation. These infants were born to mothers aged between 20 to 29 years (63.4). Most (66.1%) mothers had only attained primary school education and were married (66.1%). Majority (92%) of these mothers attended the antenatal care clinic and had the antenatal profiles done (91.1%). They lived in the rural areas (88%). Growth deficit was determined in 72.6% of the infants who were reassessed at two weeks post discharge. There was statistically significant (P=0.024) association between the gestational age of 33-37 weeks and deficit in early growth in these infants. Conclusion: The major determinants of early growth in premature infants after their hospital discharge at KDH was their gestational age at birth, the infants’ gender and any post discharge illness. Maternal age, marital status, level of education and occupation also influenced the early growth of the premature infants.