Abstract
Background and Objectives: Very low birth weight (VLBW) neonates are at risk of feed intolerance (FI) and necrotising enterocolitis. We planned this study to evaluate the risk factors for FI in VLBW neonates. Methods: Medical records of VLBW neonates admitted to the neonatal intensive care unit (NICU) during the study period were retrieved. Demographic and clinical characteristics of neonates with and without FI were studied. FI was defined as the presence of one or more of the following: Vomiting more than three times during the previous 24-h period, any episode of bile or blood-stained vomitus, an increase in abdominal girth of more 2 cm from baseline, abdominal wall erythema or tenderness, blood in stools. Factors associated with FI were identified by univariate analysis and those found significantly associated with FI were investigated using logistic regression analysis. Characteristics of neonates with Absent or reversed end diastolic doppler flow (AREDF), started on feeds within 24 h and after 24 h were also investigated. Results: Of 129 VLBW neonates enrolled in the study, 72 (55.8%) neonates experienced FI during NICU stay. The mean (standard deviation) birth weights and gestation of neonates in FI and No-FI groups were 1075 (231) and 1265 (201) grams (P < 0.01) and 29.5 (2.1) and 31.2 (2.5) weeks (P < 0.01), respectively. On univariate analysis, birth weight, gestational age and male gender were significant risk factors associated with FI. On multivariate analysis, gestational age and male gender were independent risk factors for FI in VLBW neonates. Among neonates with AREDF, there was no difference in the incidence of FI in those initiated on feeds within 24 h, versus those initiated after 24 h; 47.4%, 69.2%, respectively (P = 0.14). Conclusions: Lower gestation and male gender are significant risk factors for FI in VLBW infants. Early feeding <24 h in infants with abnormal Doppler flows is not associated with an increased risk of FI.
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