Department of Disease Prevention and Health Promotion, Benshangul Gumuze Regional Health Bureau, Assosa, Ethiopia.
Department of Epidemiology, Colleage of Public Health and Medical Science, Jimma University, Jimma, Ethiopia.
BMC Pregnancy Childbirth. 2019 Mar 29;19(1):108. doi: 10.1186/s12884-019-2243-5.
Benshangul Gumuze region is one of the regional states in Ethiopia, with highest rate of neonatal mortality rate. The trend increased at alarming rate from 42/1000 live birth in 2005 to 62/ 1000 live birth in 2011. Hence, identifying predictors of neonatal death and implement evidence based interventions at community level is crucial to reduce the mortality. Therefore, the purpose of this study was to identify predictors of neonatal mortality in Assosa zone, Western Ethiopia.
A community based matched case control study was conducted from February 1, until December 30, 2013. The study included 114 cases who died during the first 28 completed days after birth from September 1, 2010 till September 1, 2013. For each case, one alive control matched approximately by the same date of birth (-/+ 2 days) was identified from the preliminary data collected. Finally, multivariate conditional logistic regression analysis was performed; and goodness of fit of the final model was tested using likely hood ratio test. All analysis was done using EPI Info version 7 and SPSS version 16 statistical softwares.
Model households in health extension packages [AmOR = 0.32; 95%CI:0.12-0.86], age at first pregnancy < 20 years old [AmOR = 4.3;95%CI: 1.13-16.27],pregnancy complication [AmOR = 4.59; 95%CI: 1.53-13.78], delivery complication [AmOR = 2.80; 95%CI: 1.06-7.39], antenatal care visit [AmOR = 0.34;95%CI: 0.12-0.94], primipara mothers [AmOR = 3.37; 95%CI:1.05-10.78], small size neonate at birth [AmOR = 3.40: 95%CI: 1.05-11.55], gestational age < 37 weeks [AmOR = 4.35;95%CI:1.16-16.28], and home delivery [AmOR = 2.84; 95%CI:1.07-7.55] were found statistically significantly associated with neonatal mortality.
Model households in health extension package and antenatal care visit were associated with reducing risk of neonatal mortality. However, age at first pregnancy < 20 years old, primipara mothers, pregnancy complication, delivery complication, small size neonates, gestational age < 37 weeks, and home delivery were associated with increasing risk of neonatal death. Therefore, promotion of model household in health extension package, anti natal care visit, institutional delivery, family planning to prevent early age pregnancy; and improve access to basic emergency obstetric care and intensive newborn care centers are effective interventions to reduce risk of neonatal mortality at community level.
本尚古勒-古姆泽地区是埃塞俄比亚的一个州，其新生儿死亡率最高。这一趋势以惊人的速度上升，从 2005 年的每 1000 例活产 42 例增加到 2011 年的每 1000 例活产 62 例。因此，确定新生儿死亡的预测因素，并在社区层面实施基于证据的干预措施，对于降低死亡率至关重要。因此，本研究旨在确定埃塞俄比亚西部阿索萨地区新生儿死亡的预测因素。
这是一项 2013 年 2 月 1 日至 12 月 30 日进行的基于社区的匹配病例对照研究。该研究包括 114 例在 2010 年 9 月 1 日至 2013 年 9 月 1 日期间出生后 28 天内死亡的病例。对于每个病例，从初步收集的数据中确定了一个大约在同一日期（+/-2 天）出生的存活对照。最后，进行了多变量条件逻辑回归分析；并使用似然比检验来检验最终模型的拟合优度。所有分析均使用 EPI Info 版本 7 和 SPSS 版本 16 统计软件进行。
接受健康推广包的家庭[优势比（OR）=0.32；95%置信区间（CI）：0.12-0.86]、首次怀孕年龄<20 岁（OR=4.3；95%CI：1.13-16.27）、妊娠并发症（OR=4.59；95%CI：1.53-13.78）、分娩并发症（OR=2.80；95%CI：1.06-7.39）、产前护理（OR=0.34；95%CI：0.12-0.94）、初产妇（OR=3.37；95%CI：1.05-10.78）、新生儿出生时体型小（OR=3.40；95%CI：1.05-11.55）、胎龄<37 周（OR=4.35；95%CI：1.16-16.28）和家庭分娩（OR=2.84；95%CI：1.07-7.55）与新生儿死亡有统计学显著关联。
健康推广包和产前护理的家庭与降低新生儿死亡风险有关。然而，首次怀孕年龄<20 岁、初产妇、妊娠并发症、分娩并发症、新生儿体型小、胎龄<37 周和家庭分娩与新生儿死亡风险增加有关。因此，促进健康推广包和产前护理、机构分娩、计划生育以预防早育；并改善基本产科急诊护理和强化新生儿护理中心的获得途径，是降低社区新生儿死亡率的有效干预措施。
