Determinants of neonatal mortality at neonatal intensive care unit in Northeast Ethiopia: unmatched case-control study

Abebaw Yeshambel Alemu,Mengistu Berhanu,Biniam Minuye,Getaneh Mulualem Belay

doi:10.1186/s41182-020-00232-9

Abebaw Yeshambel Alemu, Mengistu Berhanu + Show 2 more

Open Access

https://doi.org/10.1186/s41182-020-00232-9

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Abstract

BackgroundGlobally, in 2016, about 38% and 3% of all neonatal death were recorded in sub-Saharan Africa and Ethiopia, respectively. In the same year, 47 neonates out of 1000 live births were not surviving in the first 28 days of age in the Amhara region, Ethiopia. Despite the highest burden of neonatal death in the region, specific or the proximate determinants of neonatal death in the neonatal intensive care unit were not well identified.ObjectiveThis study aimed to identify the determinants of neonatal mortality at neonatal intensive care unit in Dessie Referral Hospital, Northeast Ethiopia.MethodsAn institution-based unmatched case-control study was conducted on neonates admitted to the neonatal intensive care unit of Dessie Referral Hospital, from January 1, 2016, to December 30, 2017. A total of 390 charts (130 cases and 260 controls) were selected by simple random sampling technique. The data were abstracted from the facility-based data abstraction form. A binary logistic regression analysis was fitted to identify the determinants of neonatal mortality.ResultsPregnancy-induced hypertension (AOR = 4.57; 95% CI 1.45–14.43), prolonged rupture of membrane (AOR = 2.04; 95% CI 1.13–3.68), very low birth weight (AOR = 7.00; 95% CI 2.10–23.35), and low birth weight (AOR = 2.12; 95% CI 1.10–4.20) were identified factors. Moreover, respiratory distress syndrome (AOR = 3.61; 95% CI 1.10–12.04), perinatal asphyxia (AOR = 2.27; 95% CI 1.18–4.39), meconium aspiration syndrome (AOR = 2.35; 95% CI 1.12–4.97), and infection (AOR = 2.26; 95% CI 1.34–3.82) were also significantly associated with neonatal death.ConclusionsPregnancy-induced hypertension, prolonged rupture of membrane, low birth weight, respiratory distress syndrome, perinatal asphyxia, meconium aspiration syndrome, and infections were the major determinants of neonatal mortality. Therefore, special attention will be given to small and sick babies. Moreover, early anticipation of complications and management of mothers who had pregnancy-induced hypertension and prolonged rupture of the membrane would save neonates.

Highlights

In 2016, about 38% and 3% of all neonatal death were recorded in sub-Saharan Africa and Ethiopia, respectively
Pregnancy-induced hypertension, prolonged rupture of membrane, low birth weight, respiratory distress syndrome, perinatal asphyxia, meconium aspiration syndrome, and infections were the major determinants of neonatal mortality
Study setting and period The study was conducted at neonatal intensive care unit (NICU) in Dessie Referral Hospital from March 15 to April 15, 2018, which is located 401 km away from Addis Ababa, Northeast Ethiopia

Summary

Introduction

In 2016, about 38% and 3% of all neonatal death were recorded in sub-Saharan Africa and Ethiopia, respectively. Using a standard neonatal care protocol since 2014 [4] and free maternal and neonatal health services had a paramount advantage in Ethiopia [5]. According to the Ethiopian Demographic and Health Survey (EDHS, 2016) report, neonatal mortality in Ethiopia had been reduced by 41% due to the standardized neonatal care and free MCH services since 2014 [6]. Among maternal determinants that positively associated with early neonatal death were antepartum hemorrhage, pregnancy-induced hypertension, and other medical/surgical conditions [8]. Maternal age less than 20 years was positively associated with neonatal death in Brazil [10]. No antenatal care (ANC) visit was identified as a factor of early neonatal mortality in Ethiopia [11]

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