Cause and predictors of neonatal mortality among neonates admitted to the Neonatal Intensive Care Units of public Hospitals in eastern Ethiopia: Facilities based prospective follow-up study

Abstract

Background: The first month is the most crucial period for child survival and neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing this high mortality rate and it continues to be a significant public health issue. The facilities-based cause and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the cause and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data was collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and cause of death was set by pediatricians and residents. Epi-Data 3.1 and SPSS 25 Version software were used for data entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five causes of death were a complication of prematurity (49%), birth asphyxia (37.8%), infection (32.6%), meconium aspiration syndrome (17.3%) and congenital malformation (6.1%). Low birth weight, preterm births, length of stay in NICU , low 5 minute Apgar score , hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion In summary, the proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving ANC and this would lead to early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.