Getahun Genanew Kassie, Beyene Mihretu, Afework Tsion, Desalegn Mitiku, Jemberie Selamawit Shita, Shitemaw Tewodros
Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia.
Department of Public Health, Yanet Health and Business College, Addis Ababa, Ethiopia.
Front Pediatr. 2024 Feb 28;12:1352270. doi: 10.3389/fped.2024.1352270. eCollection 2024.
Addressing neonatal mortality is an important priority for improving the health and well-being of newborns. Almost two-thirds of infant deaths occur in the first month of life; among these, more than two-thirds die in their first week. Therefore, the aim of this study was to assess the mortality rate and predictors of mortality among neonates admitted to the neonatal intensive care unit (NICU) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, in 2023.
An institutional-based retrospective follow-up study was conducted using 459 neonates who were admitted to the NICU at Tikur Anbessa Specialized Hospital from January 2020 to December 2022. The data were extracted from randomly selected charts using a pretested data extraction checklist. The Nelson Alan curve with log-rank test was used to compare the presence of differences in the mortality rate of different groups over different categorical variables. The cox proportional hazards analysis model was used to identify predictors of neonatal death. The presence and absence of statistical significance was considered at a -value of less than 0.05 and the strength of association was measured using AHR.
The neonatal mortality rate was 3.1 (95% CI: 1.3-4.9) per 1,000 neonate-days. Low birth weight (AHR = 1.44: 95% CI: 1.06-3.13), exclusive breast-feeding (AHR = 0.74: 95% CI: 0.35-0.95), and time of exclusive breast-feeding (AHR = 0.92: 95% CI: 0.49-0.99) were the identified predictors of newborn mortality.
The neonatal mortality rate was high. Low birth weight of the neonate, exclusive breast-feeding initiation, and time of exclusive breast-feeding were independent predictors of neonatal death. Therefore, empowering mothers to exclusively breastfeed their children, which is a cost-effective, safe, and realistic option, can significantly minimize infant mortality.
解决新生儿死亡率问题是改善新生儿健康和福祉的重要优先事项。几乎三分之二的婴儿死亡发生在生命的第一个月;其中,超过三分之二在第一周死亡。因此,本研究的目的是评估2023年在埃塞俄比亚亚的斯亚贝巴提库尔安贝萨专科医院新生儿重症监护病房(NICU)收治的新生儿的死亡率及死亡预测因素。
采用基于机构的回顾性随访研究,研究对象为2020年1月至2022年12月在提库尔安贝萨专科医院NICU收治的459名新生儿。数据通过使用预先测试的数据提取清单从随机选择的病历中提取。采用带有对数秩检验的纳尔逊·艾伦曲线来比较不同组在不同分类变量上死亡率的差异。使用考克斯比例风险分析模型来确定新生儿死亡的预测因素。当P值小于0.05时考虑有无统计学意义,并使用调整后危险比(AHR)来衡量关联强度。
新生儿死亡率为每1000新生儿日3.1例(95%置信区间:1.3 - 4.9)。低出生体重(AHR = 1.44:95%置信区间:1.06 - 3.13)、纯母乳喂养(AHR = 0.74:95%置信区间:0.35 - 0.95)以及纯母乳喂养时间(AHR = 0.92:95%置信区间:0.49 - 0.99)是确定的新生儿死亡预测因素。
新生儿死亡率较高。新生儿低出生体重、开始纯母乳喂养以及纯母乳喂养时间是新生儿死亡的独立预测因素。因此,让母亲有能力纯母乳喂养孩子,这是一种具有成本效益、安全且切实可行的选择,可以显著降低婴儿死亡率。