Survival status and predictors of mortally among preterm neonates admitted to neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia, 2021.

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Addis Abeba University


Background: Preterm neonates have much greater risk of death and disability compared with term neonates due to immature organ system which makes them unable to tolerate the extra uterine environment. In Ethiopia almost 90% of neonatal deaths are due to three preventable causes among which preterm complications are the one. The country accepts initiatives to decrease preterm mortality and much is already being done to decrease mortality related to preterm complications. But studies about time to death in prospective design are limited. Objective: The main aim of this study is to determine survival status and predictors of mortality among preterm neonates admitted to public hospitals in Addis Ababa, 2021. Methodology: An institutional based prospective follow up study was conducted among 358 preterm neonates admitted to selected public hospitals in Addis Ababa, Ethiopia from February 12 to May 12, 2021. Ethical approval was obtained from Institutional Review Board (IRB) AAU, CHS. Data was collected prospectively using structured questioner which was adapted from previous literatures. Data was entered into Epi Data version 4.6 and exported to STATA version 14 for analysis. Descriptive statics to describe variables, the Kaplan Meier failure estimate curve to estimate the cumulative time to death and Log rank tests were used to compare probability of hazard between different categories. Bi-variable and multi-variable Cox proportional hazards models were used to identify predictor variables and variables having p value < 0.05 were considered as statistically significant. Result: At the end of this cohort, 125(34.9%) of the neonates died, with incidence rate of 36.4/1000 person-day. The first 7days after admission was the hazard time to death in which 105(84%) of preterm neonates died. Being born to APH mother (AHR: 3.1, CI; 1.4-6.6), lack of KMC (AHR: 5.8, CI; 2.37-14.33), unable to start feeding with in 24hours of admission (AHR: 6.4, CI: 3.33 -12.28), apnea (AHR: 2.4, CI: 1.3-4.7) and dehydration during the follow up period (AHR: 2.33, CI: 1.3-4.3), were identified predictors of time to death. Conclusion and Recommendation: The proportion of preterm death in this study was high compared to the pervious study conducted in Tikur Anbesa Specialized Hospital. Being born to APH mother, lack of Kangaroo Mother Care, unable to start feeding with 24hour, Apnea and dehydration were the predictors’ time to death. Therefore, intervention that focuses on the identified predictors could have a paramount effect in reducing preterm death.



Preterm, survival status, Predictors, Addis Ababa, Ethiopia