Dilla University, College of Health Science, Dilla, Ethiopia.
Addis Ababa University, College of Health Science, Addis Ababa, Ethiopia.
BMC Pediatr. 2022 Mar 23;22(1):153. doi: 10.1186/s12887-022-03176-7.
Preterm related complications are the single largest direct cause of neonatal deaths throughout the world, responsible for 35% of the world's neonatal death (1.1 million deaths/year). In Ethiopia preterm related complications are still the leading cause of neonatal mortality. Identifying the hazard time to death and predictors of mortality play an important role to decrease preterm mortality. Therefore, this study aimed to determine the survival and predictors of mortality among preterm neonates admitted to neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia, 2021.
An institutional based prospective follow up study was conducted among 358 preterm neonates admitted to selected public hospitals of Addis Ababa, Ethiopia from February 12 to May 12, 2021. Systematic random sampling was used to recruit each sample and data was collected prospectively using structured questioner. Epi-data version 4.6 and STATA version 16 was used to data entry and analysis respectively. Kaplan Meier failure curve, Log rank tests were computed. Schoenfeld residual test was used to check overall model fitness. Cox proportional hazards models were fitted to identify independent predictors of preterm mortality.
At the end of this cohort, 125(34.9%) of the neonates died, with incidence rate of 36.4/1000 (CI: 0.031-0.044) person-day with the median time to death of 6 days. Born from antepartum hemorrhage mother (AHR: 3.1, CI; 1.4-6.6), lack of Kangaroo mother care (AHR: 5.8, CI; 2.37-14.33), unable to start feeding with in 24 h of admission (AHR: 6.4, CI: 3.33-12.28), apnea (AHR: 2.4, CI: 1.3-4.7) and dehydration (AHR: 2.33, CI: 1.3-4.3) were the identified predictors of time to death.
The first 7 days of admission was the hazard time to death with median time of 6 days. Being born to antepartum hemorrhage mother, lack of Kangaroo mother care, unable to start feeding with 24-h, Apnea and dehydration were the predictors of time to death. Therefore, intervention that focuses on the identified predictors could have a paramount effect to prolong time to death and reduce preterm mortality.
早产相关并发症是全球新生儿死亡的最大单一直接原因，占全球新生儿死亡人数的 35%（每年 110 万例死亡）。在埃塞俄比亚，早产相关并发症仍然是新生儿死亡的主要原因。确定死亡的危险时间和死亡预测因素对于降低早产死亡率至关重要。因此，本研究旨在确定 2021 年在埃塞俄比亚亚的斯亚贝巴公立医院新生儿重症监护病房（NICU）收治的早产儿的生存和死亡预测因素。
2021 年 2 月 12 日至 5 月 12 日，在埃塞俄比亚亚的斯亚贝巴选定的公立医院对 358 名早产儿进行了一项基于机构的前瞻性随访研究。采用系统随机抽样方法招募每个样本，并使用结构化问卷进行前瞻性数据收集。Epi-data 版本 4.6 和 STATA 版本 16 分别用于数据输入和分析。计算 Kaplan-Meier 失败曲线、对数秩检验。Schoenfeld 残差检验用于检查总体模型拟合度。Cox 比例风险模型用于确定早产儿死亡的独立预测因素。
在本队列结束时，125 名（34.9%）新生儿死亡，发病率为 36.4/1000（CI：0.031-0.044）人天，中位死亡时间为 6 天。母亲产前出血（AHR：3.1，CI；1.4-6.6）、缺乏袋鼠式护理（AHR：5.8，CI；2.37-14.33）、不能在入院后 24 小时内开始喂养（AHR：6.4，CI：3.33-12.28）、呼吸暂停（AHR：2.4，CI：1.3-4.7）和脱水（AHR：2.33，CI：1.3-4.3）是死亡时间的识别预测因素。
入院后前 7 天是死亡的危险时间，中位时间为 6 天。出生于产前出血母亲、缺乏袋鼠式护理、不能在 24 小时内开始喂养、呼吸暂停和脱水是死亡时间的预测因素。因此，针对这些预测因素的干预措施可能会对延长死亡时间和降低早产儿死亡率产生重要影响。
