Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.
Nekemte Polly Clinic, Nekemte Town, Oromia, Ethiopia.
PLoS One. 2019 Oct 9;14(10):e0221513. doi: 10.1371/journal.pone.0221513. eCollection 2019.
Neonatal mortality is a significant contributor to infant mortality. Causes and predictors of neonatal death are known to vary in different settings and across different contexts. This study aimed to assess predictors, causes, and trends of neonatal mortality amongst neonates admitted to Nekemte Referral Hospital neonatal unit between 2010-2014.
Retrospective data was collected for 2090 live born neonates admitted to the neonatal intensive care unit of Nekemte Referral Hospital by reviewing records between 2010 to 2014. Variables were collected from the neonatal registration book and patient card on the predictors, causes, and trends of neonatal death using a standard checklist developed by the World Health Organization (WHO). Data was analyzed using Epi info version 3.5.1, and SPSS version 25 for windows. The level of significance was set at P<0.05 with the corresponding confidence intervals at 95%. A logistic regression model was used for analysis and to control for confounders. Microsoft Excel 2007 was used to construct the trend analysis.
There were 183 deaths in the cohort equivalent to 8.8% of deaths among total admitted neonates during the study period. Early neonatal deaths accounted for 8% and late neonatal deaths accounted for 0.71% of deaths among total admitted neonates. Main predictors identified for an increased risk of neonatal mortality were; neonates from rural residents [AOR 1.35, (95% CI, 1.35-1.87)], birth order of greater than five [AOR 5.10, (95% CI, 1.15-22.63)], home delivery [AOR 3.41, (95% CI, 2.24-5.19)], very low birth weight [AOR 6.75, (95% CI, 3.63-12.54)] and low birth weight [AOR 2.81, (95% CI, 1.95-4.05)] and inability to cry at birth [AOR 2.21, (95% CI, 1.51-3.22)]. The trend analysis showed a sharp fall for the neonatal mortality over the last five years with a mean reduction of 16%.
Data from the Nekemte Referral Hospital Neonatal Intensive Care Unit analysis revealed majority of the deaths were occurred during early neonatal period. The main predictors of neonatal mortality identified from this study needs strengthening an appropriate public health intervention through addressing antenatal care, curbing home delivery.
新生儿死亡率是婴儿死亡率的一个重要因素。在不同的环境和背景下，新生儿死亡的原因和预测因素是不同的。本研究旨在评估 2010-2014 年间在内克姆特转诊医院新生儿病房住院的新生儿的预测因素、原因和趋势。
通过回顾 2010 年至 2014 年期间的记录，为内克姆特转诊医院新生儿重症监护病房的 2090 名活产新生儿收集了回顾性数据。使用世界卫生组织（WHO）制定的标准检查表，从新生儿登记册和患者卡片上收集了与新生儿死亡的预测因素、原因和趋势有关的变量。使用 Epi info 版本 3.5.1 和 SPSS 版本 25 for windows 进行数据分析。采用逻辑回归模型进行分析，并控制混杂因素。使用 Microsoft Excel 2007 构建趋势分析。
在研究期间，队列中有 183 例死亡，占总住院新生儿死亡的 8.8%。早期新生儿死亡占总住院新生儿死亡的 8%，晚期新生儿死亡占总住院新生儿死亡的 0.71%。确定的增加新生儿死亡率的主要预测因素包括：农村居民的新生儿[比值比（AOR）1.35，95%置信区间（CI）1.35-1.87]、出生顺序大于 5 个[AOR 5.10，95%CI 1.15-22.63]、家庭分娩[AOR 3.41，95%CI 2.24-5.19]、极低出生体重[AOR 6.75，95%CI 3.63-12.54]和低出生体重[AOR 2.81，95%CI 1.95-4.05]以及出生时无法哭泣[AOR 2.21，95%CI 1.51-3.22]。趋势分析显示，过去五年新生儿死亡率急剧下降，平均下降 16%。
内克姆特转诊医院新生儿重症监护病房的数据分析显示，大多数死亡发生在新生儿早期。本研究确定的新生儿死亡的主要预测因素需要通过加强产前保健和遏制家庭分娩来实施适当的公共卫生干预。
