Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Abstract

The purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU). A cohort study was conducted retrospectively on 1017 preterm neonates using medical records from January 2014 through December 2018. The Kaplan–Meier model was used to estimate mean survival time and cumulative survival probability. Furthermore, Multivariable Cox regression analysis was run to identify predictors of preterm neonatal mortality using an adjusted hazard ratio (AHR) at P < 0.05 and 95% confidence interval (CI). During the follow-up period in the NICU, the mean survival time of the preterm neonates was 47 (95% CI (43.19–48.95)) days. Compound presentation (AHR = 2.29, 95% CI (1.23–4.24)), perinatal asphyxia (AHR = 2.83, 95% CI (1.75–4.58)), respiratory distress syndrome (AHR = 3.01, 95% CI (1.80–5.01)), 1-min APGAR score (AHR = 0.78, 95% CI (0.62–0.98)), and birth weight (AHR = 0.32, 95% CI (0.17–0.58)) were found to be significant predictors of time to preterm neonatal mortality. In conclusion, the survival probability of preterm neonates showed a considerable decrement in the first week of life. Fetal presentation, gestational age, birth weight, 1-min APGAR score, perinatal asphyxia and respiratory distress syndrome found as independent predictors of preterm neonatal mortality.

Escalating the limit of median survival time and predictors of mortality among preterm neonates in Northwest Ethiopia, 2021: a 1-year prospective follow-up study

“…On the other hand, the finding of this study is lower than that of the studies conducted in Bahir Dar, Ethiopia16 and Ghana 25. Moreover, in this finding is the median survival time is lower than the study conducted in Tigray region of Ethiopia,26 Bahir Dar, Ethiopia 27…”

Survival status and predictors of mortality among preterm neonates admitted in Bench Sheko Zone, Sheka Zone and Keffa Zone Governmental Hospitals, Southwest Ethiopia (2021): prospective follow-up study

“…25 This indicates that the quality of health service provision has a significant role in reducing incidence rates of neonatal mortality. Another study in Northern Ethiopia reported a better mean survival time of the preterm neonates (47.0, 95% CI: 43.1 to 48.9 days) 26 compared with this study. This discrepancy might be due to the study setting and the differences in the event of origin and survival time.…”

Predictors of Survival Among Preterm Neonates Admitted to Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

“…Different studies have been done on preterm neonates in Ethiopia; however, the majority of them used <4 year's data (17)(18)(19)(20), and all of these studies did not investigate the independent predictors (time Abbreviations: AHR, adjusted hazard ratio; ANC, antenatal care; AOR, adjusted odd ratio; ARR, adjusted relative risk; CI, confidence interval; CPAP, continuous positive airway pressure; CS, cesarean section; HMD, hyaline membrane disease; HR, hazard ratio; KMC, kangaroo mother care; LBW, low birth weights; NEC, necrotizing entro colitis; NICU, neonatal intensive care unit; OR, odd ratio; PIH, pregnancy induced hypertension; PNA, peri natal asphyxia; PROM, premature rupture of membrane; RDS, respiratory distress syndrome; RR, relative risk; SVD, spontaneous vaginal delivery; UNICEF, united nation international children's emergency fund; WHO, world health organization. of breastfeeding initiated, gestational age and admission/birth weight) of preterm survival (17)(18)(19)(20)(21)(22)(23). Furthermore, some studies employed a cross-sectional type of study design, usually unable to make a causal inference (17,20).…”