Zekarias Wongel, Shemsu Mubarek, Abdulkadr Ahmed Abduletif, Aychiluhm Setognal Birara
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Medicine, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Heliyon. 2024 Jun 15;10(12):e32924. doi: 10.1016/j.heliyon.2024.e32924. eCollection 2024 Jun 30.
In Ethiopia, despite various strategies and interventions being implemented, the rate of neonatal mortality remains high. Despite numerous published articles in Ethiopia, there is a lack of sufficient data regarding the time to death and its predictors in neonatal mortality, especially in pastoral communities like the Afar region. Therefore, this study aims to evaluate neonatal mortality and its predictors among neonates admitted to the neonatal intensive care unit at Dubti General Hospital, Northeast Ethiopia.
We conducted a facility-based retrospective follow-up study, involving a sample of 479 neonates admitted to the neonatal intensive care unit at Dubti General Hospital. Data entry was performed using Epi-Data version 4.6, and subsequent analysis was carried out using STATA version 14.1. To identify predictors of neonatal mortality, we applied the Cox-proportional hazard model.
Out of the total, 87 neonates (18.16 %) passed away. The overall incidence of neonatal mortality was 27.2 deaths per 1000 neonate-days spent in the neonatal intensive care unit, with a 95 % confidence interval of [21.8, 34.2]. Appearance, pulse, grimace, activity, and respiration score less than or equal to 5 [AHR = 0.33, 95%CI: 0.07, 0.62], respiratory distress syndrome [AHR = 3.22, 95%CI: 1.71, 6.07], Neonatal hypothermia [AHR = 3.12, 95%CI: 1.31, 7.42]. No initiation of breastfeeding [AHR = 3.68, 95%CI: 1.44, 9.36], no antenatal care visits [AHR = 0.25, 95%CI: 0.13, 0.48] and maternal birth related complication [AHR = 2.71, 95%CI: 2.43, 11.14] are predictors.
The mortality rate was notably high, with several factors identified as independent predictors of newborn death, including Appearance, pulse, grimace, activity, and respiration, respiratory distress syndrome, hypothermia, initiation of breastfeeding, antenatal care visits, and maternal birth-related complications. There is a pressing need for intensified programming efforts aimed at improving child survival within healthcare facilities, particularly addressing neonatal complications. Enhancing prenatal care during pregnancy and early detection and treatment of intrapartum disorders are recommended strategies for enhancing newborn health outcomes.
在埃塞俄比亚，尽管实施了各种策略和干预措施，但新生儿死亡率仍然很高。尽管埃塞俄比亚发表了大量文章，但关于新生儿死亡时间及其预测因素的数据仍然不足，尤其是在像阿法尔地区这样的牧区社区。因此，本研究旨在评估埃塞俄比亚东北部杜布提综合医院新生儿重症监护病房收治的新生儿的死亡率及其预测因素。
我们进行了一项基于机构的回顾性随访研究，样本包括杜布提综合医院新生儿重症监护病房收治的479名新生儿。使用Epi-Data 4.6版本进行数据录入，并使用STATA 14.1版本进行后续分析。为了确定新生儿死亡的预测因素，我们应用了Cox比例风险模型。
总共有87名新生儿（18.16%）死亡。新生儿重症监护病房每1000个新生儿日的总体死亡率为27.2例死亡，95%置信区间为[21.8, 34.2]。外貌、脉搏、 grimace、活动和呼吸评分小于或等于5 [风险比（AHR）= 0.33，95%置信区间：0.07, 0.62]、呼吸窘迫综合征 [AHR = 3.22，95%置信区间：1.71, 6.07]、新生儿体温过低 [AHR = 3.12，95%置信区间：1.31, 7.42]、未开始母乳喂养 [AHR = 3.68，95%置信区间：1.44, 9.36]、未进行产前检查 [AHR = 0.25，95%置信区间：0.13, 0.48] 以及产妇分娩相关并发症 [AHR = 2.71，95%置信区间：2.43, 11.14] 是预测因素。
死亡率显著较高，有几个因素被确定为新生儿死亡的独立预测因素，包括外貌、脉搏、 grimace、活动和呼吸、呼吸窘迫综合征、体温过低、开始母乳喂养、产前检查以及产妇分娩相关并发症。迫切需要加强规划努力，以改善医疗机构内的儿童生存状况，特别是解决新生儿并发症问题。建议在孕期加强产前护理，并对产时疾病进行早期检测和治疗，以改善新生儿健康结局。
