Predictors of Neonatal Mortality Among Neonates Admitted to NICU at Dubti General Hospital, Northeast Ethiopia

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Jul 15

PMID 39005898

Authors

Wongel Zekarias

Mubarek Shemsu

Ahmed Abduletif Abdulkadr

Setognal Birara Aychiluhm

Affiliations

Soon will be listed here.

Abstract

Background: In Ethiopia, despite various strategies and interventions being implemented, the rate of neonatal mortality remains high. Despite numerous published articles in Ethiopia, there is a lack of sufficient data regarding the time to death and its predictors in neonatal mortality, especially in pastoral communities like the Afar region. Therefore, this study aims to evaluate neonatal mortality and its predictors among neonates admitted to the neonatal intensive care unit at Dubti General Hospital, Northeast Ethiopia.

Method: We conducted a facility-based retrospective follow-up study, involving a sample of 479 neonates admitted to the neonatal intensive care unit at Dubti General Hospital. Data entry was performed using Epi-Data version 4.6, and subsequent analysis was carried out using STATA version 14.1. To identify predictors of neonatal mortality, we applied the Cox-proportional hazard model.

Results: Out of the total, 87 neonates (18.16 %) passed away. The overall incidence of neonatal mortality was 27.2 deaths per 1000 neonate-days spent in the neonatal intensive care unit, with a 95 % confidence interval of [21.8, 34.2]. Appearance, pulse, grimace, activity, and respiration score less than or equal to 5 [AHR = 0.33, 95%CI: 0.07, 0.62], respiratory distress syndrome [AHR = 3.22, 95%CI: 1.71, 6.07], Neonatal hypothermia [AHR = 3.12, 95%CI: 1.31, 7.42]. No initiation of breastfeeding [AHR = 3.68, 95%CI: 1.44, 9.36], no antenatal care visits [AHR = 0.25, 95%CI: 0.13, 0.48] and maternal birth related complication [AHR = 2.71, 95%CI: 2.43, 11.14] are predictors.

Conclusion: The mortality rate was notably high, with several factors identified as independent predictors of newborn death, including Appearance, pulse, grimace, activity, and respiration, respiratory distress syndrome, hypothermia, initiation of breastfeeding, antenatal care visits, and maternal birth-related complications. There is a pressing need for intensified programming efforts aimed at improving child survival within healthcare facilities, particularly addressing neonatal complications. Enhancing prenatal care during pregnancy and early detection and treatment of intrapartum disorders are recommended strategies for enhancing newborn health outcomes.

References

Ndombo P, Ekei Q, Tochie J, Temgoua M, Angong F, Ntock F . A cohort analysis of neonatal hospital mortality rate and predictors of neonatal mortality in a sub-urban hospital of Cameroon. Ital J Pediatr. 2017; 43(1):52. PMC: 5460331. DOI: 10.1186/s13052-017-0369-5. View

Orsido T, Asseffa N, Berheto T . Predictors of Neonatal mortality in Neonatal intensive care unit at referral Hospital in Southern Ethiopia: a retrospective cohort study. BMC Pregnancy Childbirth. 2019; 19(1):83. PMC: 6396455. DOI: 10.1186/s12884-019-2227-5. View

Tewabe T, Mehariw Y, Negatie E, Yibeltal B . Neonatal mortality in the case of Felege Hiwot referral hospital, Bahir Dar, Amhara Regional State, North West Ethiopia 2016: a one year retrospective chart review. Ital J Pediatr. 2018; 44(1):57. PMC: 5963133. DOI: 10.1186/s13052-018-0498-5. View

Owusu B, Lim A, Makaje N, Wobil P, SameAe A . Neonatal mortality at the neonatal unit: the situation at a teaching hospital in Ghana. Afr Health Sci. 2019; 18(2):369-377. PMC: 6306982. DOI: 10.4314/ahs.v18i2.22. View

Roro E, Tumtu M, Gebre D . Predictors, causes, and trends of neonatal mortality at Nekemte Referral Hospital, east Wollega Zone, western Ethiopia (2010-2014). Retrospective cohort study. PLoS One. 2019; 14(10):e0221513. PMC: 6785121. DOI: 10.1371/journal.pone.0221513. View

Debelew G, Afework M, Yalew A . Determinants and causes of neonatal mortality in Jimma Zone, Southwest Ethiopia: a multilevel analysis of prospective follow up study. PLoS One. 2014; 9(9):e107184. PMC: 4169420. DOI: 10.1371/journal.pone.0107184. View

Tessema Z, Tesema G . Incidence of neonatal mortality and its predictors among live births in Ethiopia: Gompertz gamma shared frailty model. Ital J Pediatr. 2020; 46(1):138. PMC: 7507277. DOI: 10.1186/s13052-020-00893-6. View

Doku D, Neupane S . Survival analysis of the association between antenatal care attendance and neonatal mortality in 57 low- and middle-income countries. Int J Epidemiol. 2017; 46(5):1668-1677. PMC: 5837573. DOI: 10.1093/ije/dyx125. View

Seid S, Ibro S, Ahmed A, Akuma A, Reta E, Haso T . Causes and factors associated with neonatal mortality in Neonatal Intensive Care Unit (NICU) of Jimma University Medical Center, Jimma, South West Ethiopia. Pediatric Health Med Ther. 2019; 10:39-48. PMC: 6519704. DOI: 10.2147/PHMT.S197280. View

10.

Masaba B, Mmusi-Phetoe R . Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa. J Multidiscip Healthc. 2020; 13:709-716. PMC: 7398680. DOI: 10.2147/JMDH.S260058. View

11.

Aluvaala J, Collins G, Maina B, Mutinda C, Wayiego M, Berkley J . Competing risk survival analysis of time to in-hospital death or discharge in a large urban neonatal unit in Kenya. Wellcome Open Res. 2019; 4:96. PMC: 6611136. DOI: 10.12688/wellcomeopenres.15302.1. View

12.

Alebel A, Wagnew F, Petrucka P, Tesema C, Moges N, Ketema D . Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study. BMC Pediatr. 2020; 20(1):72. PMC: 7023807. DOI: 10.1186/s12887-020-1963-z. View

13.

Bitew Z, Alemu A, Ayele E, Jember D, Haile M, Worku T . Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Int J Pediatr. 2020; 2020:3894026. PMC: 7586147. DOI: 10.1155/2020/3894026. View

14.

Lona Reyes J, Perez Ramirez R, Llamas Ramos L, Gomez Ruiz L, Benitez Vazquez E, Rodriguez Patino V . Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit. Arch Argent Pediatr. 2018; 116(1):42-48. DOI: 10.5546/aap.2018.eng.42. View

15.

Haileamlak A . Is Neonatal Mortality Rate in Ethiopia Going from Bad to Worse?. Ethiop J Health Sci. 2022; 32(3):472. PMC: 9214751. DOI: 10.4314/ejhs.v32i3.1. View

16.

Farah A, Abbas A, Ahmed A . Trends of admission and predictors of neonatal mortality: A hospital based retrospective cohort study in Somali region of Ethiopia. PLoS One. 2018; 13(9):e0203314. PMC: 6138366. DOI: 10.1371/journal.pone.0203314. View

17.

Demisse A, Alemu F, Gizaw M, Tigabu Z . Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia. Pediatric Health Med Ther. 2018; 8:57-64. PMC: 5774602. DOI: 10.2147/PHMT.S130309. View

18.

Basha G, Woya A, Tekile A . Determinants of neonatal mortality in Ethiopia: an analysis of the 2016 Ethiopia Demographic and Health Survey. Afr Health Sci. 2020; 20(2):715-723. PMC: 7609081. DOI: 10.4314/ahs.v20i2.23. View