Pediatric and Child Health Nursing, University of Gondar, Gondar, Ethiopia
University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.
BMJ Paediatr Open. 2023 May;7(1). doi: 10.1136/bmjpo-2023-001897.
Early neonatal death accounts for a significant number of under-5 mortality worldwide. However, the problem is under-researched and under-reported in low-income and middle-income countries, particularly in Ethiopia. The magnitude of mortality during the early neonatal period and associated factors should be studied for designing appropriate policies, and strategies that could help tackle the problem. Hence, this study aimed to determine the prevalence and identify factors associated with early neonatal mortality in Ethiopia.
This study was conducted by using data from Ethiopian Demographic and Health Survey 2016. A total of 10 525 live births were enrolled in the study. A multilevel logistic regression model was used to identify determinants of early neonatal mortality. Adjusted OR (AOR) at a 95% CI was computed to assess the strength and significance of the association between outcome and explanatory variables. Factors with a p<0.05 were declared statistically significant.
The national prevalence of early neonatal mortality in Ethiopia was 41.8 (95% CI 38.1 to 45.8) early neonatal deaths per 1000 live births. The extreme ages of pregnancy (under 20 years (AOR 2.7, 95% CI 1.3 to 5.5) and above 35 years (AOR 2.4, 95% CI 1.5 to 4)), home delivery (AOR 2.4, 95% CI 1.3 to 4.3), low birth weight (AOR 3.3, 95% CI 1.4 to 8.2) and multiple pregnancies (AOR 5.3, 95% CI 4.1 to 9.9) were significantly associated early neonatal mortality.
This study revealed a higher prevalence of early neonatal mortality as compared with prevalence in other low-income and middle-income countries. Thus, it is determined to be essential to design maternal and child health policies and initiatives with a priority on the prevention of early neonatal deaths. Emphasis should be given to babies born to mothers at extreme ages of pregnancy, to those born of multiple pregnancies delivered at home and to low birthweight babies.
全球范围内，早期新生儿死亡占五岁以下儿童死亡人数的很大比例。然而，在低收入和中等收入国家，这一问题的研究和报告都不足，尤其是在埃塞俄比亚。为了制定适当的政策和战略来解决这一问题，有必要研究早期新生儿期的死亡率及其相关因素。因此，本研究旨在确定埃塞俄比亚早期新生儿死亡率的流行程度，并确定其相关因素。
本研究使用了 2016 年埃塞俄比亚人口与健康调查的数据。共有 10525 例活产纳入本研究。采用多水平逻辑回归模型确定早期新生儿死亡的决定因素。使用 95%置信区间（CI）计算调整后的比值比（AOR），以评估结局与解释变量之间的关联强度和显著性。具有 p<0.05 的因素被宣布为具有统计学意义。
埃塞俄比亚全国范围内，早期新生儿死亡率为每 1000 例活产中有 41.8 例（95%CI 38.1 至 45.8）早期新生儿死亡。妊娠极端年龄（<20 岁（AOR 2.7，95%CI 1.3 至 5.5）和>35 岁（AOR 2.4，95%CI 1.5 至 4））、家庭分娩（AOR 2.4，95%CI 1.3 至 4.3）、低出生体重（AOR 3.3，95%CI 1.4 至 8.2）和多胎妊娠（AOR 5.3，95%CI 4.1 至 9.9）与早期新生儿死亡显著相关。
与其他低收入和中等收入国家的流行率相比，本研究显示出更高的早期新生儿死亡率。因此，有必要制定母婴健康政策和计划，优先预防早期新生儿死亡。应重点关注妊娠极端年龄的母亲所生婴儿、家庭分娩的多胎婴儿和低出生体重婴儿。
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