Survival status and predictors of mortally among preterm neonates admitted to neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia, 2021.
No Thumbnail Available
Date
2021-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
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.
Description
Keywords
Preterm, survival status, Predictors, Addis Ababa, Ethiopia