Maternal risk factors for prematurity related neonatal mortality among preterm neonates admitted to Neonatal Intensive Care Unit of selected referral Hospitals in Addis Ababa

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Background: The neonatal period is considered high risk period in terms of mortality. Globally, approximately 15 million infants are born prematurely each year, which is more than one tenth of all newborn infants. Mortality due to complications of prematurity is the leading cause of neonatal and children under five age death. Little is known about specific maternal risk factors for prematurity related neonate mortality. Objective: The aim of the proposed study was to identify risk factors for prematurity related neonate mortality. Methods: A facility based nested unmatched case control study design was employed to identify maternal risk factors for prematurity related neonatal mortality. Cases were preterm neonates who died and controls were preterm neonates who survived 28 days of neonatal period among those admitted to NICU ward. The study was conducted from July 25, 2016 to May 29, 2017 at neonatal intensive care units of three Referral hospitals in Addis Ababa city. The total sample size was 471 with 157 cases and 314 controls. Data was entered using Epi Info 7 and analyzed by STATA 12. Bivariate and multivariate logistic regression models were applied to measure the associations between the prematurity related mortality and maternal risk factors. Results: The mean/median gestational age of cases and controls were 30.6/30 and 33.6/34 weeks respectively. The mean (±SD) age of the mothers of cases was 25.8(±4.6) years and that of mothers of controls was 26.6(±4.7) years. Having no formal education [AOR (95% C.I): 6.586 (2.467, 7.582)], ANC visit [AOR (95% C.I): 2.791 (1.604, 4.857)], maternal anemia during pregnancy [AOR (95% C.I): 2.921 (1.396, 6.112)], urine test suggesting infection [AOR (95% C.I): 3.513 (1.261, 9.787)], and antepartum hemorrhage [AOR: (95% CI): 3.151 (1.509 , 6.577)] were found to be risk factors for preterm neonatal mortality. Conclusion and recommendations: Maternal education, poor antenatal care, maternal anemia, and ante partum hemorrhage have strong association with mortality among premature babies. Reduction of mortality among premature babies requires multi-sectorial response. The Ministry of Health (MOH) should give more emphasis to strengthening routine antenatal care and management of obstetric complications like antepartum hemorrhage. The Ministry of Education (MOE) on the other hand should pay special attention to women’s higher education; Promotion of proper maternal nutrition could be enhanced through joint effort of the ministries of education and health.



Prematurity related neonatal mortality, maternal factors, Addis Ababa