Survival Status and Predictors of Mortality among Neonates Admitted to Neonatal Intensive Care Unit in Dessie Referral Hospital, Northeast Ethiopia, 2021.
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Date
2021-06
Authors
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Publisher
Addis Abeba University
Abstract
Background: The first 28-days of life, particularly the day of birth, are the most challenging
and vulnerable time for a child’s survival and health. Neonatal deaths as a share of under-five
deaths decreased more slowly than mortality among children aged 1–59 months and accounted
for 47 percent of all under-five deaths. Moreover, Ethiopia is still on the 4
rank of
global and sub-Saharan Africa neonatal mortality rate, respectively, which indicates neonatal
death is a critical problem which needs farther studying of the underline predictors. Even though,
some studies were conducted on predictors and determinants of neonatal mortality in Ethiopia,
little is known about the time to neonatal death and its predictors. Therefore, this study aimed
to assess the survival status and predictors of mortality among neonates admitted to NICU in
Dessie Referral Hospital. Objectives: To determine the survival status and predictors of
mortality among neonates admitted to NICU from 01/01/2018-31/12/2020 in Dessie Referral
Hospital, Northeast Ethiopia, 2021. Methods: An institution-based retrospective cohort study
was used among 542 neonates admitted from 2018-2020 in NICU of Dessie Referral Hospital,
Northeast Ethiopia. Medical record numbers were obtained from patient register logbooks. Then
data was collected from patient cards by using a systematic sampling method with pretested
checklist. Data was entered using Epi-data 4.6 and analyzed using STATA 16. Kaplan Meier
was used to estimating median survival time and cumulative probability of survival, and the logrank
test
was
used
to
compare
survival
curves.
The
Cox
proportional
hazard
regression
model
was used to analyze the relationship between independent and outcome variables. Results: Out
of 542 eligible participant neonates, 104 (19.19%) died with an overall incidence rate of 35.54
(95%CI: 29.33, 40.08) deaths/1000 neonate-days observations. The overall median survival
time was 14 days, with an overall cumulative survival probability of 36.10%. Low birth weight
(AHR: 3.03, 95%CI: 1.53, 6.00), prolonged labor (AHR: 3.32, 95%CI: 1.46,7.53), primiparous
mother (AHR: 2.23, 95%CI: 1.44, 3.45), preeclampsia (AHR: 2.17, 95%CI: 1.10, 4.25),
Diabetic mother (AHR: 3.74, 95%CI: 1.57, 8.90), PNA (AHR: 2.61, 95%CI: 1.11, 6.13), and
neonatal anemia (AHR: 9.14, 95%CI: 3.33, 25.08) were independent predictors of death.
Conclusion: The incidence of death was 35.54 per 1000 neonate-day and LBW, primipara
mother, prolonged labor, preeclampsia, maternal DM, PNA, neonatal anemia were identified as
independent predictors of time to death of neonates. Keywords: Neonate, Survival Status,
Neonatal Mortality, Predictors, Time to Death
Description
Keywords
Mortality ,Neonates,Neonatal intensive care unit