School of Public Health, Hawassa, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
BMC Pediatr. 2020 Jan 27;20(1):33. doi: 10.1186/s12887-019-1907-7.
The first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. In Ethiopia, despite a significant reduction in under-five mortality during the last 15 years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia.
A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan-Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates' survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant.
The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR = 3.643; 95% CI, 1.36-9.77), male neonates (AHR = 2.71; 95% CI, 1.03-7.09), neonates that mothers perceived to be small (AHR = 3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after 1 h (AHR = 3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR = 3.07; 95% CI, 1.16-8.12).
Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.
生命的头 28 天是儿童生命延续面临的最大挑战。在埃塞俄比亚，尽管在过去 15 年中五岁以下儿童死亡率显著下降，但新生儿死亡率仍然是一个公共卫生问题，占五岁以下儿童死亡人数的 47%。了解新生儿的生存情况和导致新生儿死亡的因素有助于制定有针对性的干预措施。本研究旨在确定阿罗萨雷萨地区的新生儿生存情况和导致新生儿死亡的因素。
本研究为社区前瞻性随访研究，纳入了 2018 年 1 月 1 日至 3 月 30 日期间分娩的足月孕妇及其新生儿。采用多阶段抽样技术选择了 586 名足月孕妇，对 584 名新生儿进行了 28 天的随访，其中有 12 对双胞胎。数据经过编码、输入、清理后，使用 SPSS 版本 22 进行分析。采用 Kaplan-Meier 生存曲线显示 28 天内新生儿死亡的模式。使用 Cox 回归模型评估不同预测因素与新生儿生存的独立和调整关系。通过风险比和 95%置信区间探索并呈现死亡率，并认为 P 值小于 0.05 具有统计学意义。
新生儿总死亡率为每 1000 例活产 41 例。有并发症的新生儿（AHR=3.643；95%CI，1.36-9.77）、男婴（AHR=2.71；95%CI，1.03-7.09）、母亲认为较小的新生儿（AHR=3.46；95%CI，1.119-10.704）、出生后 1 小时内开始纯母乳喂养的新生儿（AHR=3.572；95%CI，1.255-10.165）和未接受产后护理的母亲（AHR=3.07；95%CI，1.16-8.12）的新生儿死亡风险较高。
研究地区的新生儿死亡率为 4.1%，死亡率较高，应立即采取行动，以实现可持续发展目标。为了提高新生儿的生存率，建议采取高影响力的干预措施，如促进孕产妇服务的利用、基本新生儿护理和尽早开始纯母乳喂养。
