Determinants of neonatal near miss among neonates admitted to public hospitals in Southern Ethiopia, 2021: A case-control study

Abstract

Background Neonatal near-miss (NNM) cases refer to situations in which babies are on the verge of dying between the ages of 0 and 28 days due to severe morbidity that occurs during pregnancy, delivery, or extra-uterine life, but survive either by luck or due to high-quality health care. Identifying NNM cases and addressing their determinants is crucial for devising comprehensive and relevant interventions to tackle neonatal morbidity and mortality. Hence, this study aimed at finding out the determinants of NNM in neonates admitted to public hospitals in Hadiya zone, southern Ethiopia. Methods A hospital-based unmatched case-control study was conducted in three selected hospitals in southern Ethiopia from May 1 to June 30, 2021. A total of 484 participants took part in the study (121 cases and 363 controls). Controls were chosen using systematic sampling approaches, whereas cases were recruited consecutively at the time of discharge. Cases were selected based on the Latin American Centre for Perinatology (CLAP) criteria of an NNM. A structured interviewer-administered questionnaire and a data extraction checklist were used for data collection. The Data were entered into Epi-Data version 3.1 and exported to SPSS version 23 for analysis. A multivariable logistic regression analysis with a p-value of <0.05 was used to determine the determinants of NNM. Results Ninety-seven (80.1%) and 56 (46.2%) near-miss cases encountered at least one pragmatic and management criteria, respectively. The most common pragmatic and management criteria were gestational age less than 33 weeks (44.6%) and intravenous antibiotic usage up to 7 days and before 28 days of life (27.3%), respectively. A short birth interval [AOR = 2.15, 95% CI: 1.29, 3.57], lack of ANC [AOR = 3.37; 95%CI: 1.35, 6.39], Caesarean mode of delivery [AOR = 2.24; 95%CI: 1.20, 4.16], the occurrence of a third maternal delay [AOR = 3.47; 95% CI: 2.11, 5.75], and poor birth preparedness and complication readiness (BPCR) plan[AOR = 2.50; 95% CI: 1.49,4.13] were identified as a significant determinants of NNM. Conclusion and recommendation The provision of adequate ANC should be a priority for health care providers at service delivery points. To avoid serious neonatal problems, mothers who deliver by Cesarean section should receive more attention from their families and health care providers. Health care providers in the ANC unit should encourage pregnant women to implement the WHO-recommended elements of the BPCR plan. To achieve optimal birth spacing, healthcare providers should focus on the contraceptive provision. Unnecessary delays in health facilities during childbirth should be avoided at all costs.

Incidence of Adverse Perinatal Outcomes among Women Exposed to Maternal Near-Misses in Arsi Zone in Ethiopia: Prospective Cohort Study in 2022

“…In this study, exposed women who were treated after half an hour (faced delay three) in the hospital were more than six times more likely to have adverse perinatal outcomes than nonexposed women (AOR = 6.40, 95% CI: 1.5–27.54). This finding is similar to studies done in Malaysia [ 30 ], Brazil [ 25 ], India [ 31 ], Mozambique [ 32 ], and Ethiopia [ 33 ] in that adverse perinatal outcomes were highly linked to third delay. This could be explained by the dearth of qualified and skilled personnel, inadequate staff, limited supply of medicine and equipment, poor facility situations, and poor attitudes and care on the part of healthcare workers which might be all possible explanations for the third delay, and interested parties working on the maternal and neonatal health should prioritize overcoming these impediments.…”

Adverse birth outcomes and associated factors among newborns delivered in a western African country: a case‒control study

“…If a mother lacks ANC, minor obstetric conditions are not detected and managed early; therefore, serious complications and ABO will likely develop [52]. Our finding is similar to the results from Ethiopia and other LMICs, in which adverse birth outcomes, especially PTB and LBW, were higher among mothers with limited ANC visits [8,18,53]. The recommendation of eight or more ANC contacts was only introduced in 2016 by the World Health Organization (WHO) since studies at that time concluded that eight or more ANC contacts could reduce perinatal deaths by up to 8 per 1000 births when compared to only 4 visits, as previously recommended by the WHO for LMICs [54].…”

Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study

“…The most important aspect of this study for public health is that it identifies potential characteristics that predispose newborns to life-threatening conditions, which is critical to address the underlying causes and provide prompt interventions by various stakeholders in the healthcare system (74).…”