Department of Public Health, College of Medical and Health Sciences, Samara University, Afar Region, Samara, Ethiopia.
PLoS One. 2021 Mar 17;16(3):e0242481. doi: 10.1371/journal.pone.0242481. eCollection 2021.
Neonatal mortality is a public health issue in, Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged in developing regions of the country. Regrettably, there is no single study to show the rates and predictors of neonatal mortality for Afar region. Thus, this study aims to assess neonatal mortality and associated factors in Afar region, Ethiopia.
A health facility-based cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care units (NICUs) from January 2015 to December 2019. Maternal and neonatal medical records were reviewed and audited using structured data extraction checklist. The data was collected by four trained nurses and midwives. The medical records were selected using a systematic random sampling technique. Bivariate and multivariable logistic regression analyses were done. Adjusted odds ratio with the corresponding 95% confidence interval were used to assess the association between neonatal mortality and the associated factors. Finally, the statistical significance level was declared at a p-value of less than 0.05.
In this study, 391 medical records of newborns were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 57 (14.6%) [95% CI 11.0%-18.4%]. A multivariable logistic regression showed that lack of antenatal care (ANC) follow up [AOR = 4.69: 95%CI (1.77, 12.47)], giving birth through cesarean section [AOR 3.59, 95%CI (1.22, 10.55)], having admission temperature less than 36.5°C [AOR 10.75, 95%CI (3.75, 30.80)], birth asphyxia [AOR 7.16, 95%CI (2.22, 23.10)], and having a length of stay greater than five days in the hospital [AOR 0.23, 95%CI (0.08, 0.66)] were significantly associated with neonatal mortality.
This study revealed that the rate of neonatal mortality is still high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature at admission and birth asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention to improve antenatal care, intrapartum care and standardized care for admitted neonates. Furthermore, prospective studies are recommended.
新生儿死亡率是埃塞俄比亚的一个公共卫生问题。不幸的是，该问题明显报告不足且低估，因此无法在该国的发展中地区了解其真实严重程度。遗憾的是，没有一项研究能够显示阿法尔地区的新生儿死亡率及其相关预测因素。因此，本研究旨在评估埃塞俄比亚阿法尔地区的新生儿死亡率及其相关因素。
2015 年 1 月至 2019 年 12 月期间，对入住新生儿重症监护病房（NICU）的 403 名新生儿进行了一项基于医疗机构的横断面研究。对母婴医疗记录进行了回顾和审核，并使用结构化数据提取清单进行了审核。数据由四名经过培训的护士和助产士收集。使用系统随机抽样技术选择医疗记录。进行了单变量和多变量逻辑回归分析。使用调整后的优势比及其相应的 95%置信区间来评估新生儿死亡率与相关因素之间的关联。最后，将统计显著性水平定义为 p 值小于 0.05。
本研究中，包括了 391 份新生儿的病历，数据完整率为 97.02%。新生儿死亡率为 57 例（14.6%）[95%CI 11.0%-18.4%]。多变量逻辑回归显示，缺乏产前保健（ANC）随访[AOR=4.69：95%CI（1.77，12.47）]，剖宫产分娩[AOR 3.59，95%CI（1.22，10.55）]，入院时体温低于 36.5°C[AOR 10.75，95%CI（3.75，30.80）]，出生窒息[AOR 7.16，95%CI（2.22，23.10）]和住院时间超过五天[AOR 0.23，95%CI（0.08，0.66）]与新生儿死亡率显著相关。
本研究表明，与国家数据相比，新生儿死亡率仍然很高。产前保健、剖宫产分娩、住院时间、入院时体温低和出生窒息是与新生儿死亡率相关的因素。因此，医疗机构应重视改善产前保健、分娩期保健和对住院新生儿的标准化护理。此外，建议开展前瞻性研究。
