Evidence map›Paper›PMID 39915788›Full record

Observational studyItalian journal of pediatrics2025

How long does it take to start minimal enteral feeding in preterm Neonates admitted to NICUs in Southern Oromia, Ethiopia?

Anteneh Fikrie, Terefu Yambo, Alo Edin, Miesa Gelchu, Dejene Hailu, Mark Spigt

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anteneh FikrieSchool of Public Health, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia. antenehfikrie3@gmail.com.ORCID http://orcid.org/0000-0002-9809-3326
Terefu YamboSchool of Public Health, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia.
Alo EdinSchool of Public Health, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia.
Miesa GelchuSchool of Public Health, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia.
Dejene HailuSchool of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Mark SpigtDepartment of Family Medicine, School for Public Health and Primary Care (CAPHRI), Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Peter Debyeplein 1, 6229 HA Maastricht, Maastricht, 6200 MD Maastricht, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe timely initiation of trophic feeding (TF) is crucial for premature newborns, but challenging due to immaturity, respiratory instability, abdominal distension, resource scarcity, and healthcare worker expertise. Moreover, there is a dearth of information on predictors of full trophic feeding time. Therefore, this retrospective cohort study aimed to investigate the time it takes and its predictors to initiate minimal enteral feeding in preterm neonates in Southern Oromia, Ethiopia.

methodA facility-based retrospective follow up study was conducted among 434 randomly selected preterm neonates admitted to NICU of Bule Hora University Teaching Hospital and Yabello General Hospital from January 1, 2021 to December 30, 2022. Data were extracted by a pretested structured checklist, entered into Epidata 3.1 and then transferred to Stata version 17 for analysis. Kaplan Meier survival curve and log rank test were used to estimate survival time and a statistical comparison respectively. Bivariable and multivariable cox proportional hazard model was fitted to identify predictors of time to initiate TF and their outputs are presented using Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CIs).

resultThe overall incidence density of TF initiation was reported as 43.6 per 100 neonate-days. Moreover, the median (IQR) time to initiate TF was found to be 2 (1-4) days. Neonates delivered vaginally had a higher likelihood of early TF initiation (AHR: 1.64, CI: 1.26, 2.13), while those born between 32 and 34 weeks (AHR: 0.61, CI: 0.46, 0.81), VLBW neonates (AHR: 0.45, CI: 0.34, 0.60), neonates without KMC (AHR: 0.59, CI: 0.46, 0.79), and those in level II hospitals were less likely to start TF promptly (AHR: 0.78, CI: 0.62, 0.99). Furthermore, neonates with sepsis (AHR: 1.76, CI: 1.36, 2.28) and hypothermia (AHR: 1.51, CI: 1.19, 1.93) had delayed TF initiation.

conclusionWe observed a significant low rate of early TF initiation and higher death rate of preterm newborn in our study as compared to the global. Preterm neonates with lower GA, no KMC, and a VLBW are more likely to have a delayed initiation. Our results highlight that staff training on identifying neonates suitable for TF, and ensuring adequate resources for KMC in all NICU levels should be considered.

Indexed as

Enteral NutritionInfant, PrematureIntensive Care Units, NeonatalTime FactorsTime-to-TreatmentBirth WeightClinical CompetenceEthiopiaFemaleFollow-Up StudiesGestational AgeHumansIncidenceInfant, NewbornInfant, Very Low Birth WeightKaplan-Meier EstimateEarly trophic feedingPredictorsPreterm neonatesSurvival analysis

Identifiers

PMID39915788
PMCPMC11803979

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.