Time to initiate trophic feeding and predictors among preterm neonates admitted at General Hospitals in Tigray, 2025

Back ground Trophic feeding generally refers to providing small quantities of enteral feeding soon after birth. As a result this study is aimed to assess time to initiation of TF and its predictors among preterm neonate in Tigray region.

A prospective, institutional-based follow-up study was conducted on 193 preterm neonates admitted to the Neonatal intensive care unit, with participants’ selected using systematic random sampling from a group of public hospitals. Data collection period was from December 20, 2024 to February 30, 2025. Data was entered into Epi data version 4.7 and then exported to STATA version 14 for cleaning and analysis. To compare survival curves, Kaplan-Meier analysis and the log-rank test was used, bivariate and multivariate Cox regression analysis were used, all statistical tests was considered significant at a p-value of <0.05.

A total of 193 neonates were followed for 8382 person-hours of risk time and 173 (89.6%) of neonates were initiated trophic feeding. The incidence rate of initiating trophic feeding was 2 per 100 person hours’ observations with a median time of 45 hours (95% CI: 42-56). Birth weight <1500 gram (AHR: 0.16,95% CI:0.075-0.35), APGAR score at first minute < 7 (AHR: 0.46,95% CI:0.26-0.76),APGAR score at fifth minute < 7 (AHR: 0.38,95%CI :0.21-0.68,, having respiratory distress syndrome (AHR: 0.41,95% CI:0.25-0.66, and absence of Kangaroo mother care (AHR: 0.41,95% CI:0.21-0.77), were statistically Significant associated factors for the delay of initiation of trophic feeding.

In this study, a significant delay in the initiation time of trophic feeding and several predictors were identified. Therefore, health institutions should work on these predictors to shorten the initiation time and reduce complications associated with the delay. Competing Interest Statement The authors have declared no competing interest. Funding Statement The author(s) received no specific funding for this work. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: An official ethical clearance letter was obtained from the Axum University College of Health Sciences Institutional Review Board (IRB) on 03 December 2024 with Protocol of Approval AKU-IRB 095/2024 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Data Availability All relevant data are within the manuscript and its Supporting Information files. Abbreviations - APGAR - Appearance, Pulse, Grammies, Activity, Respiration - BW - Birth weight - TF - Trophic Feeding - GA - Gestational Age - KMC - Kangaroo Mother Care - NEC - Necrotized Enterocolitis - NICU - Neonatal Intensive Care Unit - PNA - Perinatal Asphyxia - RDS - Respiratory Distress Syndrome - TF - Trophic feeding,