Magnitude and predictors of mortality among preterm neonates admitted in NICU at Debre markos and Felegehiwot specialized hospitals in east and west Gojjam zones, Amhara reginal state, Ethiopia, 2020; a retrospective cohort study.

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Addis Abeba University


Backgrounds: Premature neonatal death is a global burden both in developed and developing countries. Despite, different strategies and interventions were implemented to reduce premature neonatal complications including death, the rate of neonatal mortality in Ethiopia are too far from the targets. The objective: the aim of this study is to determine magnitude and predictors of mortality among preterm neonates admitted to neonatal intensive care unit from 2016-2019 in NICU of Debre markos and Felegehiwot specialized hospitals in Amhara region, Ethiopia. Method: an institution based retrospective cohort study in two specialized hospitals of Debre markos and Felegehiwot in East and West Gojjam zones, Amhara regional state, among all 432 preterm neonates admitted and enrolled in NICU treatment from 1 st of January, 2016 to the 1 st of February, 2019 after getting ethical clearance from Institutional Review board of Addis Ababa University, College of Health sciences, school of Nursing and Midwifery and department of nursing using a structured checklist to gather information. The data abstraction tool was developed from related literatures with some modification and the neonatal national guideline which are currently used in NICU in hospitals. Data was entered into and cleared using epidata software version 3.1 and then has been exported to SPSS version 24 for further statistical analysis. Data was analyzed using SPSS version 24 for windows. The level of significance was set at P<0.05 with the corresponding confidence intervals at 95%. A logistic regression model was used for analysis and to control for confounders. Result: The magnitude of mortality among preterm neonates admitted to neonatal intensive care unit of public hospitals was 160(37%) with (95%CI; 58.8%%,-67.6%). Variables of premature rupture of membrane{AOR: 2.14(95%CI=1.098, 4.20)}, neonatal sepsis{AOR: 2.80, (95%CI=1.46, 5.40)}, respiratory distress {AOR: 2.28, (95%CI=1.32, 3.95)}, Perinatal asphyxia{AOR: 2.85, (95%CI: 1.34, 6.10)}, Gestational age of the preterm neonates (28-31 weeks){AOR: 2.55, (95%CI=1.356, 4.80)}, low birth weight of 1000-1499 and less than 1000 grams{AOR:3.274, (95%CI=1.54, 6.97)} and {AOR: 10.34(95%CI=1.6, 7,20)} respectively) and length of hospital stay less than or equal to one and 2-7days {AOR: 9.63, (95%CI=3.35, 7.70)} and {AOR; 5.45, (95%CI: 2.37, 12.52} )respectively were significantly associated Predictors of preterm neonatal mortality. Conclusion: In the current study, a total of 160(37.0%) neonates were died during the follow up period. Magnitude of death was found to be high particularly in early neonatal period and multivariate analysis showed that the major predictors of death of preterm neonates admitted to NICU were found to be premature rupture of membrane, neonatal sepsis, respiratory distress syndrome, gestational age less than 32 weeks, weight of the preterm neonates less than 1500grams and length of hospital stay less than 2 days were found to be significantly associated predictors of preterm neonatal death.



Magnitude of mortality, predictors, gestational age, Preterm neonate, occurrence of death.