Abstract

BackgroundDespite the incredible progress made in decreasing under-five mortality, neonatal mortality remains the main and slowly advancing contributor. Though all efforts were made to decline the death of a newborn, current information showed that newborn death is unaverted and not a fastened agenda. This study aimed to assess neonatal mortality and its determinants among neonates admitted at the Dil Chora Hospital in Dire Dawa City.MethodsFacility-based cross-sectional study design was employed. A total of 376 newborns were selected systematically from neonates admitted to the NICU of the Dil Chora Referral Hospital from June 1, 2017 to December 31, 2020. Data were collected from medical records using a standard extraction checklist. The data were entered into Epi-data version 3.1 and then exported into SPSS version 24 for statistical analysis. Bivariate and multivariate analyses were employed to identify the association between independent variables and neonatal death.ResultThe prevalence of neonatal death was 11.4% (95% CI: 9.44, 13.36). The majority of 37 (86.05%) of the neonates died within 7 days of life. The most common causes of admission included perinatal asphyxia (55.3%), hypoglycemia (21.5%), and hypothermia. Nearly half (40.4%) of the mothers of newborns experience index pregnancy complications, premature rupture of the membrane (AOR = 5.79, 95% CI: 2.08, 16.1), birth weight <2,500 g (AOR = 3.96, 95% CI: 1.56. 10.06), hypothermia (AOR = 2.54, 95% CI: 1.1, 6.02), index pregnancy complications (AOR = 4.79, 95% CI: 1.92, 11.91), and induced labor (AOR = 4.45, 95% CI: 1.53, 12.94), which were significantly associated with neonatal mortality.ConclusionThe prevalence of neonatal mortality was high compared with the national target. Premature rupture of the membrane, birth weight <2,500 g, hypothermia, index pregnancy complications, and induced labor were significantly associated with neonatal mortality. The majority of neonatal deaths are due to complications arising from pregnancy, labor, and delivery, and lack of quality of care at the neonatal intensive care unit. Cultivating and increasing the utilization of antenatal care services, quality of care at delivery, and the neonatal intensive care unit could avert those deaths.

Highlights

  • The first 28 days of life is an extremely susceptible time for a newborn to complete many of the physiologic adjustments required for life outside the uterus, which makes it the most dangerous period in life [1, 2]

  • A facility-based cross-sectional study was conducted in the neonatal intensive care unit (NICU) of the Dil Chora Referral Hospital in Dire Dawa City administration

  • Neonatal mortality was 4.11 times more likely (AOR = 4.11; 95% CI: 1.53, 11.03) to occur among women who did not attend Antenatal care (ANC) visits at least once compared with their counterparts

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Summary

Introduction

The first 28 days of life is an extremely susceptible time for a newborn to complete many of the physiologic adjustments required for life outside the uterus, which makes it the most dangerous period in life [1, 2]. Neonates in need of serious medical attention are admitted to the neonatal intensive care unit (NICU), which incorporates innovative technology and trained staff to effectively provide specialized care for neonates [3]. Despite the incredible progress made in decreasing underfive mortality, neonatal mortality remains the main and slowly advancing contributor. From 5.3 million under-five deaths, around 47% of deaths occurred in the neonatal period [4].

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