Background Although respiratory distress is one of the major causes of neonatal morbidity and mortality throughout the globe, it is a particularly serious concern for nations like Ethiopia that have significant resource limitations. Additionally, few studies have looked at neonatal respiratory distress and its predictors in developing countries, and thus we sought to investigate this issue in neonates who were admitted to the Neonatal Intensive Care Unit at Black Lion Specialized Hospital, Ethiopia. Methods An institution-based retrospective follow-up study was conducted with 571 neonates from January 2013 to March 2018. Data were collected by reviewing patients' charts using a systematic sampling technique with a pretested checklist. The data was then entered using Epidata 4.2 and analyzed with STATA 14. Median time, Kaplan-Meier survival estimation curves, and log-rank tests were then computed. Bivariable and multivariable Gompertz parametric hazard models were fitted to detect the determinants of respiratory distress. The hazard ratio with a 95% confidence interval was subsequently calculated. Variables with reported p-values < 0.05 were considered statistically significant. Results The proportion of neonates with respiratory distress among those admitted to the Black Lion Specialized Hospital neonatal intensive care unit was 42.9% (95%CI: 39.3-46.1%) The

BACKGROUND፡ Preterm neonatal death is a global problem. In Ethiopia, it is still high, and the trend in reduction is slower as compared to child mortality. Preterm neonatal birth is the leading cause. The magnitude and associated factors are also not well documented. Therefore, this study aimed to estimate the incidence of mortality and its predictors among preterm neonates in Tikur Anbesa Specialized Hospital (TASH).METHODS: An institution-based retrospective cohort study was conducted among 604 preterm neonates admitted to Tikur Anbesa Specialized Hospital. Data were collected by reviewing patient charts using systematic sampling with a checklist. The data entry was done using EpiData version 4.2, and analysis was done using Stata Version 14.1. Kaplan-Meier and log-rank tests were used to estimate the survival time and to compare it. Cox proportional hazard was also fitted to identify major predictors. Hazard Ratios (HRs) with 95% Confidence Intervals (CI) were used to assess the relationship between factors associated with the occurrence of death. Finally, statistical significance was declared at p-value < 0.05.RESULTS: In this study, a total of 604 patient charts were reviewed; of these, 571 met the inclusion criteria and were recruited to the study. A total of 170(29.7%) preterm neonates died during the follow-up period. The median follow-up time of preterm neonate under the cohort was 21 days (IQR: 4, 27). The incidence rate was 39.1 per 1000-person day. Rural residency (AHR: 1.45 (95% CI: 1.1,4.8)), Maternal diabetic Mellitus (AHR:2.29 (95%CI: 1.43,3.65), neonatal sepsis (AHR:1.62 (95% CI: 1.11,2.37), respiratory distress (AHR:1.54 (95% CI:1.03,2.31), extreme prematurity (AHR:2.87 (95% CI:1.61, 5.11), and low APGAR score (AHR:3.11 (95% CI:1.79, 5.05) was found to be predictors .CONCLUSION: The rate of preterm neonatal mortality is still an important problem. Having maternal gestational Diabetic Mellitus, neonatal sepsis, respiratory distress, and low Apgar score were major predictors for preterm neonatal mortality. Therefore, efforts have to be made to reduce the incidence of death and for timely management of mothers with Diabetic Mellitus. Healthcare professionals should also work on early diagnosis and treatment of preterm neonate with sepsis, respiratory distress, and low Apgar score.

Background: Although Respiratory distress is one of the major causes of neonatal morbidity and mortality throughout the globe, it is a serious concern more of in resource limited nations, like Ethiopia. Besides, few studies are available in developing countries. Data from different settings is needed to tackle it. Therefore, we intended to assess the incidence and predictors of respiratory distress among neonates who were admitted in neonatal Intensive care unit (NICU) at Black Lion Specialized Hospital, Ethiopia. Methods: Institution-based retrospective follow-up study was conducted among 571 neonates from January 2013 to March 2018. Data were collected by reviewing patients chart using systematic sampling technique with a pretested checklist; entered using Epi-data 4.2 and analyzed with STATA 14. Median time, Kaplan-Meier survival estimation curve and Log-rank test were computed. Bivariable and multivariable Gompertz parametric hazards models were fitted to detect the determinant of respiratory distress. Hazard ratio with a 95% confidence interval was calculated. Variables with reported p-values < 0.05 were considered statistically significant. Results: The proportion of respiratory distress among of neonates admitted in Black Lion specialized hospital neonatal intensive care unit was 42.9 % (95%CI: 39.3-46.1%) with incidence of 8.1/100(95%CI: 7.3, 8.9)).Being male [AHR=2.4 (95%CI:1.1,3.1)], neonates born via caesarean section [AHR:1,.9((95%CI:1.6,2.3)], home delivery [AHR :2.9 (95%CI:1.5, 5,2)], maternal diabetes mellitus [AHR 2.3(95%CI: 1.4 ,3.6)], preterm birth [AHR:2.9(95%CI:1.6, 5.1)] and APGAR score less than 7 [AHR: 3.1 (95%CI:1.8,5.0)] were found to be significant predictors of respiratory distress. Conclusions: The incidence of respiratory distress among neonates was found to be high. Those neonates delivered at home, delivered through caesarean section, preterm neonates, whose APGAR score<7, and born from diabetic mothers were more likely to develop respiratory distress. All concerned bodies should work on preventing RD and give special attention for multifactorial cause of it .Thus; it is indicated to promote health institutional delivery more. Besides, a need to establish and/or strengthen strategies to prevent the occurrence of respiratory distress among babies with low APGAR score, preterm babies, born from diabetes mellitus mothers, and delivered through caesarean section.

BackgroundPreterm neonatal death is a global burden in both developed and developing countries. In Ethiopia, it is the first and fourth cause of newborn and under-5 deaths, respectively. From 2015 to present, the government of Ethiopia showed its effort to improve the survival of neonates, mainly preterm births, through the inclusion of high-impact life-saving neonatal interventions. Despite these efforts, the cause of preterm neonatal death is still not reduced as expected. Therefore, this study aimed to identify determinants of preterm neonatal mortality.MethodsAn institution-based retrospective case–cohort study was conducted among a cohort of preterm neonates who were born between March 2013 and February 2018. A total of 170 cases were considered when the neonates died during the retrospective follow-up period, which was confirmed by reviewing a medical death certificate. Controls were 404 randomly selected charts of neonates who survived the neonatal period. Data were collected from patient charts using a data extraction tool, entered using EpiData V.3.1 and analysed using STATA V.14. Finally, a multivariate logistic regression analysis was performed, and goodness of fit of the final model was tested using the likelihood ratio test. Statistical significance was declared at a p value of ≤0.05.ResultsIn this study, the overall incidence rate of mortality was 39.1 (95% CI: 33.6 to 45.4) per 1000 neonate-days. Maternal diabetes mellitus (adjusted OR (AOR): 2.3 (95% CI: 1.4 to 3.6)), neonatal sepsis (AOR: 1.6 (95% CI: 1.1 to 2.4)), respiratory distress (AOR: 1.5 (95% CI: 1.1 to 2.3)), extreme prematurity (AOR: 2.9 (95% CI: 1.61 to 5.11)), low Apgar score (AOR: 3.1 (95% CI: 1.79 to 5.05)) and premature rupture of membranes (AOR: 2.3 (95% CI: 1.8 to 3.5)) were found to be predictors.ConclusionIn this study, the overall incidence was found to be high. Premature rupture of membranes, maternal diabetes mellitus, sepsis, respiratory distress, extreme prematurity and low Apgar score were found to be predictors of neonatal mortality. Therefore, it should be better to give special attention to patients with significantly associated factors.