Abstract
Background: Intraventricular hemorrhage (IVH) is a serious complication in preterm infants, particularly in low-resource settings where total parenteral nutrition (TPN) is unavailable. This study explores the relationship between early enteral feeding with partial parenteral nutrition and IVH incidence in a resource-limited neonatal intensive care unit (NICU).
Methods: A retrospective cohort study was conducted on 88 preterm infants admitted to a NICU without TPN access. IVH was classified by cranial ultrasound. Early feeding was defined as achieving full enteral nutrition (≥150 mL/kg/day) by day 7 of life. Statistical analysis included chi-square tests and binary logistic regression to identify independent predictors of IVH.
Results: The mean gestational age was 28.4 ± 2.1 weeks, and the mean birth weight was 1.15 ± 0.32 kg. The overall incidence of IVH was 23.9%, with 17.0% of infants experiencing Grade II or higher. IVH occurred in 18.8% of the early feeding group and 25.0% of the delayed group (p = 0.837). While this difference was not statistically significant, it trends toward protective effect (χ² = 5.20, p = 0.268). However, the longer time to reach full feeds was significantly associated with increased odds of developing intraventricular hemorrhage (IVH) (OR = 1.13, 95% CI: 1.01–1.26, p = 0.030).
Conclusion: While early achievement of full enteral feeding showed a trend toward reduced IVH incidence, it was not statistically significant. Future multicenter studies with larger sample sizes and a control group receiving TPN are needed to determine the impact of early feeding on IVH risk, particularly in low-resource settings.
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