Mengesha Hayelom Gebrekirstos, Sahle Berhe W
College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia.
School of Pharmacy, Mekelle University, Mekelle, Ethiopia.
BMC Public Health. 2017 Jan 11;17(1):62. doi: 10.1186/s12889-016-3979-8.
Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia.
A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home.
Of the1152 live births, there were 68 deaths (63 per 1000 live births). Two thirds of deaths were attributable to prematurity 23 (34%) or asphyxia 21 (31%). Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35%) was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas.
Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.
尽管儿童死亡率显著下降，但全球新生儿死亡率几乎没有随之下降。困境在于发展中国家缺乏死亡原因记录，在这些国家，生命事件登记几乎不存在。了解新生儿死亡原因对于指导公共卫生干预措施很重要。本研究确定了埃塞俄比亚新生儿死亡的常见原因。
在埃塞俄比亚提格雷地区的七家医院对2014年4月至2014年7月出生的新生儿进行了一项前瞻性队列研究。助产士就危险因素和婴儿存活情况对母亲进行了访谈。对于在医院死亡的新生儿，从医疗记录中提取死亡原因，而对于在家中死亡的婴儿，采用口头尸检方法推定死亡原因。
在1152例活产中，有68例死亡（每1000例活产中有63例）。三分之二的死亡归因于早产23例（34%）或窒息21例（31%）。新生儿早期和晚期的死亡模式略有差异。在新生儿早期，37%是由于早产，而窒息（35%）在新生儿晚期更为常见。所有与感染相关的死亡都发生在农村地区的新生儿-母亲二元组中。
在研究期间，早产、窒息和感染是提格雷地区新生儿死亡的主要原因。新生儿早期和晚期死亡确定的原因不同，这清楚地表明需要采取针对性的循证干预措施和政策。
