College of Health Sciences and Medicine, Department of Public Health, Debre Birhan University, Debre Birhan, Ethiopia.
College of Health Sciences and Medicine, Department of Public Health, Dilla University, Dilla, Ethiopia.
Pan Afr Med J. 2021 Feb 22;38:201. doi: 10.11604/pamj.2021.38.201.20650. eCollection 2021.
even though newborn health is apriority agenda in Ethiopia, neonates' risk of dying is unacceptable and one of the ten countries which accounts to two-third of global neonatal death. The magnitude and risk of death in the referral care facility was not well studied in the study area. This study was aimed to estimate neonatal death and its determinant.
a prospective cohort study was conducted from November 2016 to January 2018 among neonates admitted to Dilla University Referral Hospital Neonatal Intensive Care Unit. We generated descriptive statistics and Cox-proportional hazard model to identify independent risk factors of neonatal death.
we identified 913 neonates with 6836 person-days of follow-up. Overall, 11.6% (n = 106) deaths of neonates were recorded. The estimated hazard ratios of neonatal death were higher among neonates whose mothers did not attend ANC follow up (HR=3.23), delivery assisted by TBA (HR=2.19), and maternal age ≥ 30 years at birth (HR=2.04). Urban residence [HR=0.54], family size of ≤ 3 (HR=0.47) and family size of 4 - 6 (HR=0.49), absence of abortion (HR=0.55), absence of illness during pregnancy (HR=0.47), iron folate intake (HR=0.29), birth weight ≥ 2500 grams (HR=0.43) were found to be protective factors.
neonatal death at referral neonatal intensive care unit was relatively high. Early management of complications, improving quality of services at neonatal intensive care unit and ensuring maternal continuum of care are recommended to increase survival of neonates. Besides, maternal and neonatal health-related factors were among the independent risk factors that need to design context-based policy and interventions.
尽管新生儿健康是埃塞俄比亚的优先事项，但新生儿的死亡风险仍然过高，该国是导致全球三分之二新生儿死亡的 10 个国家之一。在该研究地区，转诊护理机构中新生儿死亡的规模和风险尚未得到充分研究。本研究旨在评估新生儿死亡及其决定因素。
2016 年 11 月至 2018 年 1 月，在迪拉大学转诊医院新生儿重症监护病房对入院新生儿进行了前瞻性队列研究。我们生成了描述性统计数据和 Cox 比例风险模型，以确定新生儿死亡的独立危险因素。
我们共纳入了 913 名新生儿，随访 6836 人日。总体而言，有 11.6%（n=106）的新生儿死亡。母亲未接受 ANC 随访（HR=3.23）、由 TBA 辅助分娩（HR=2.19）以及母亲分娩时年龄≥30 岁（HR=2.04）的新生儿死亡风险更高。与城市居民（HR=0.54）、家庭规模≤3 人（HR=0.47）和家庭规模 4-6 人（HR=0.49）、无堕胎史（HR=0.55）、孕期无疾病史（HR=0.47）、摄入铁叶酸（HR=0.29）、出生体重≥2500 克（HR=0.43）的新生儿相比，这些因素被认为是保护性因素。
转诊新生儿重症监护病房的新生儿死亡率相对较高。建议早期管理并发症，提高新生儿重症监护病房的服务质量，并确保产妇连续护理，以提高新生儿的生存率。此外，产妇和新生儿健康相关因素是需要制定基于背景的政策和干预措施的独立危险因素之一。
