Survival Status and Predictors of Mortality among Low-birth-weight Neonates Admitted to Neonatal Intensive Care Unit in Suhul General Hospital, Northern Ethiopia: a Retrospective Cohort Study 

Abstract

Background: Low birth weight (LBW) is defined by the WHO as newborn weight less than 2500 grams. It accounts for 60–80% of all neonatal deaths, relatively higher in developing countries such as Ethiopia. Government, NGOs and private sectors have been working enormously, but the reduction of LBW neonatal mortality is still low. To provide appropriate care and reduce LBW neonatal mortality, identifying the survival time and predictors of mortality is necessary, particularly in Tigrai region. Objective: to determine the survival status and predictors of mortality among LBW neonates admitted to Suhul General Hospital, Northern Ethiopia from January 2021 – September 2023. Methods and materials: a retrospective cohort study was done for 329 LBW neonates admitted to Suhul General Hospital between January 2021 and September 2023. Variables were collected from medical registration books and patient charts using KoboCollect software. Data was analyzed using SPSS version 27 and Stata version 15 soft wares. Kaplan Meier survival curve was used to estimate the cumulative survival time, log rank test was used to compare the probability of hazard among groups/variables and bivariate and multivariate were used to identify predictors of mortality at (p-value<0.05). Finally, those variables with multivariate cox regression p value < 0.05 were considered as statistically significant. Results: 71 (21.56%) of LBW neonates were died with incidence rate of 30.26 (95%CI: 23.98-38.19) per 1000 person-day The overall mortality at the end of 1st, 3rd and 7th day was 53.5%, 81.7% and 98.6%, respectively. Median survival time was 52 days. Not feeding at all (AHR: 6.58; 95% CI: 3.08-14.05), formula feeding (AHR: 3.18; 95% CI: 1.01-10.03), and weight at discharge <1500 grams (AHR: 9.09; 95% CI: 1.87-44.10) were statistically significant predictors of LBW neonatal mortality at (p-value < 0.05). Conclusion and recommendations: This study showed that majority of the deaths were occurred during early hospitalization and the main predictors were weight at discharge <1500 grams, and not feeding (EBF) at all and formula feeding. Therefore, promotion and initiation of breastfeeding immediately (within one hour) after birth, intensive follow up to the admitted LBW neonates, particularly during the first 24 hours, availing necessary medical equipment such as CPAP, and improvement of the hospitals’ set-up to inaugurate breastfeeding corners are among the prioritized intervention measures to improve the survival status of LBW neonates.