Predictors of Neonatal mortality in Neonatal intensive care unit at referral Hospital in Southern Ethiopia: a retrospective cohort study

Abstract

Background The first one month of life; the neonatal period is the most risky time for child survival. In Ethiopia, neonatal mortality is unacceptably high, and the trend in reduction is slower as compared to infant and child mortality. The magnitude and associated factors of neonatal mortality in a tertiary care facility were not well documented. Therefore, the aim of this study was to determine neonatal mortality and predictors among neonates admitted to neonatal intensive care unit of Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia. Methods A retrospective cohort study design was done among neonates admitted to neonatal intensive care unit of a University Teaching and Referral Hospital from 2015 to 2017. Data were collected using data extraction checklist from the medical registry. The main outcome was the occurrence of death within the first four weeks. The survival time was calculated in days between the date of admission and the date of death. Kaplan-Meier survival was used to depict the pattern of death in 28 days and Cox-Proportional model was used to identify the predictors of the neonatal mortality. Results A total of 964 neonates which contributed to 5889 neonates-days were included in the study. There were 159 neonatal deaths during the follow-up time. Overall, the neonatal mortality incidence was 27 per 1000 neonates-days. Predictors of neonatal mortality were: multiple birth, mothers who did not attend antenatal care visits, neonates born by cesarean section, not initiated breast feeding within 1 h of birth, neonates resuscitated, hyaline membrane disease and perinatal asphyxia. Conclusion Neonatal mortality at neonatal intensive care unit was high. Managing neonatal complications, initiating breast feeding within 1 h of birth, promoting antenatal care visits, improving quality of services and ensuring continuum of care are recommended to increase survival of neonates.

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

“…Preterm and low birth weight babies were more likely to be prone to complications such as hypothermia, infections, and birth asphyxia (resulting in tissue hypoxia and multi-organ failure). Therefore, provisions of quality neonatal care, including quality resuscitation, thermal care, and appropriate feeding, are important to avert some of these factors [34][35][36][37].…”

Magnitude and determinants of newborn mortality in neonatal intensive care unit hospitals in Ethiopia: a systematic review and meta-analysis

“…All studies were published from 2012 to 2019. Six of the studies identified employed hospital-based cohort designs [24][25][26][27][28][29]; the remaining four applied cross-sectional designs [30,31] ( Table 1).…”

The magnitude of neonatal mortality and its predictors in Ethiopia: a systematic review and meta-analysis

“…The findings of these uneven studies documented that there was a great variability in the prevalence of neonatal mortality across the regions of the country. Concerning predictors, these studies revealed that different maternal, neonatal and health service related factors influenced neonatal mortality; maternal residency [ [16,17]], history of antenatal, gestational age ,neonatal sepsis, RDS, asphyxia were some of the factors associated with neonatal mortality [18,19].Globally, there are different policies, strategies, and programs which work on prevention and care of neonate [20,21]. However, it is sustained as the most cause of under-five mortality worldwide [11,[22][23][24][25].Despite different strategies, health policies (like HSDP IV 2010-2015) and interventions were implemented to prevent and care neonatal death, the rate of neonatal mortality is high.…”