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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Date
2020-06
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Addis Abeba University
Abstract
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.
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Keywords
Magnitude of mortality, predictors, gestational age, Preterm neonate, occurrence of death.