埃塞俄比亚阿姆哈拉州北绍阿地区部分公立医院新生儿重症监护病房收治的低出生体重新生儿的死亡率及其预测因素：多中心回顾性随访研究
Incidence and predictors of mortality among low birth weight neonates admitted to neonatal intensive care unit in selected public hospitals, North Shoa zone, Amhara Region, Ethiopia: multi-center retrospective follow-up study.
作者信息
Mengstie Leweyehu Alemaw, Gebeyehu Mohammed Tessema, Zeneb Teklehaimanot Wegayehu, Shibabaw Shiferaw Wondimeneh, Kebede Tirusew Nigussie, Abemie Worku, Girma Bekahegn
机构信息
School of Nursing and Midwifery, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia.
University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
出版信息
Front Pediatr. 2025 Jun 11;13:1524966. doi: 10.3389/fped.2025.1524966. eCollection 2025.
BACKGROUND
Birth weight of less than 2,500 g is the leading cause of neonatal morbidity and mortality. Various studies in developed and developing countries examine the prevalence and associated factors. However, little is known about low birth weight neonatal incidence and predictors of Mortality in Ethiopia.
OBJECTIVE
The study aimed to assess the incidence and predictors of mortality among low birth weight neonates admitted to the neonatal intensive care unit at a public hospital, in Northeast, Ethiopia, 2021.
METHODS
An institution-based retrospective follow-up study was conducted among 416 low-birth-weight neonates admitted to the neonatal intensive care unit from January 1, 2019 to December 30, 2021. Epi-data version 3.1 was used for data entry and Stata14 software for analysis. The Kaplan-Meier survival curve and the Log-rank test were used to estimate the cumulative survival time and compare the probability of survival time among variables. Multi-variable and bi-variable Cox proportional hazard model was used to identify predictor variables.
RESULTS
Out of 416 Low birth weight neonates, 107 (25.72%) (95% CI: 21.51, 29.93) of them died. The overall incidence rate of mortality was 42.83 per 1,000 (95% CI: 35.34, 51.77) with 2,498 person-days of observation. Twin pregnancy [adjusted hazard ratio (AHR): 1.7 (95% CI: 1.42, 3.29)], Sepsis (AHR: 1.5; 95% CI: 1.01, 2.32), respiratory distress syndrome (AHR: 1.6; 95% CI: 1.15, 2.68), maternal history of HIV (AHR: 2.2; 95% CI: 1.54, 3.42), maternal DM (AHR: 2.5; 95% CI: 1.70, 3.87) and preeclampsia (AHR: 1.8; 95% CI: 1.23, 2.73) were found to be significant predictors of low birth weight (LBW) neonatal mortality.
CONCLUSION
The incidence rate of low birth weight neonatal mortality was high and continues as a public health issue. Therefore, special attention should be given to those identified predictors of mortality, and different measures should be implemented to prevent premature birth in the high-risk population by improving prenatal care.
背景
出生体重低于2500克是新生儿发病和死亡的主要原因。发达国家和发展中国家的各种研究调查了其患病率及相关因素。然而，关于埃塞俄比亚低出生体重新生儿的发病率和死亡率预测因素知之甚少。
目的
本研究旨在评估2021年埃塞俄比亚东北部一家公立医院新生儿重症监护病房收治的低出生体重新生儿的死亡率及其预测因素。
方法
对2019年1月1日至2021年12月30日期间收治到新生儿重症监护病房的416例低出生体重新生儿进行了一项基于机构的回顾性随访研究。使用Epi-data 3.1进行数据录入，Stata14软件进行分析。采用Kaplan-Meier生存曲线和对数秩检验来估计累积生存时间，并比较各变量之间的生存时间概率。使用多变量和双变量Cox比例风险模型来确定预测变量。
结果
在416例低出生体重新生儿中，107例（25.72%）（95%置信区间：21.51，29.93）死亡。总死亡率为每1000人中有42.83例（95%置信区间：35.34，51.77），观察天数为2498人日。双胎妊娠[调整后风险比（AHR）：1.7（95%置信区间：1.42，3.29）]、败血症（AHR：1.5；95%置信区间：1.01，2.32）、呼吸窘迫综合征（AHR：1.6；95%置信区间：1.15，2.68）、母亲有HIV病史（AHR：2.2；95%置信区间：1.54，3.42）、母亲患有糖尿病（AHR：2.5；95%置信区间：1.70，3.87）和先兆子痫（AHR：1.8；95%置信区间：1.23，2.73）被发现是低出生体重（LBW）新生儿死亡的重要预测因素。
结论
低出生体重新生儿死亡率较高，仍然是一个公共卫生问题。因此，应特别关注那些已确定的死亡预测因素，并通过改善产前护理对高危人群采取不同措施预防早产。
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