Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia: A facility-based prospective follow-up study

Abstract

Background: The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa, including Ethiopia. This region shows the least progress in reducing neonatal mortality and continues to be a significant public health issue. In this study setting, the causes and predictors of neonatal death in the neonatal intensive care units are not well documented. Hence, this study aimed to determine the causes and predictors of neonatal mortality among infants admitted to neonatal intensive care units in eastern Ethiopia. Methods: A facility-based prospective follow-up study was conducted among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia from November 1 to December 30, 2018. Data were collected using a pre-tested structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis, respectively. Multivariable logistic regression was used to identify the predictors of facility-based neonatal mortality.Results: The proportion of facility-based neonatal mortality was 20%(95% CI:16.7-23.8%). The causes of death were complications of preterm birth (28.58%), birth asphyxia (22.45%), neonatal infection (18.36%), meconium aspiration syndrome (9.18%), respiratory distress syndrome (7.14%), and congenital malformation (4.08%). Low birth weight, preterm births, length of stay in the neonatal intensive care unit, low 5 minutes APGAR score, hyperthermia, and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals in eastern Ethiopia.Conclusions: The proportion of facility-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving the timing and quality of antenatal care is essential for early detection, anticipating high-risk newborns, and timely interventions. Furthermore, early initiation of feeding and better referral linkage to tertiary health facilities could lead to a reduction in neonatal death in this setting.

Neonatal Mortality and Its Associated Factors among Neonates Admitted to Wollega University Referral Hospital Neonatal Intensive Care Unit, East Wollega, Ethiopia

“…This finding is supported with the studies done in Libya and in Ethipia, Jigjiga-Sheik Hassan Yabare Referral Hospital, Dessie referral hospitals, Eastern part of Ethiopia public hospitals and Black lion hospital. 10,15,20,21 In fact, prematurely delivered baby faced different complications as a result of difficulty in adapting to extra-uterine environment and consequently are at risk of different complications compared to term babies Therefore, they need more special attention to reduce neonatal mortality.…”

“…5 As the prevailing evidence on neonatal mortality was very few to initiate structured intervention, implementation of MDG-4 was unfortunately not effective as planned. 9,10 Subsequently, identifying the magnitude and determining the factors associated with neonatal death is an evidence for inventions and a fundamental to tackle the burden of neonatal deaths. 11,12 However, there was a general shortage of studies on neonatal mortality in the study area.…”

Survival Status and Predictors of Mortality Among Preterm Neonates Admitted to Mizan Tepi University Teaching Hospital, South West Ethiopia

“…8 From public hospitals in Eastern Ethiopia, around 28.58% of neonatal deaths were due to preterm complications. 9 In Mizan Tepi University Teaching Hospital (MTUTH), from all neonatal deaths (22.8%), more than two-thirds (76%) of deaths were caused by prematurity. 10 The sustainable development goal three emphasizes reducing neonatal deaths with a goal of 12 neonatal deaths per 1000 live births per country by 2030 through different interventions.…”

Neonatal Death Incidence in Healthcare Facility in Indonesia: Does Antenatal Care Matter?

“…The Ethiopian study put the proportion of neonatal deaths in health facilities at 20%. The causes of neonatal mortality included preterm birth 28.58, birth asphyxia 22.45%, neonatal infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14%, congenital malformations 4.08% 7 . Previous studies reported that neonatal mortality in health facilities was 13.3% or about 30 deaths per 1000 live births.…”