Abstract
BackgroundThe first one month of life; the neonatal period is the most risky time for child survival. In Ethiopia, neonatal mortality is unacceptably high, and the trend in reduction is slower as compared to infant and child mortality. The magnitude and associated factors of neonatal mortality in a tertiary care facility were not well documented. Therefore, the aim of this study was to determine neonatal mortality and predictors among neonates admitted to neonatal intensive care unit of Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia.MethodsA retrospective cohort study design was done among neonates admitted to neonatal intensive care unit of a University Teaching and Referral Hospital from 2015 to 2017. Data were collected using data extraction checklist from the medical registry. The main outcome was the occurrence of death within the first four weeks. The survival time was calculated in days between the date of admission and the date of death. Kaplan-Meier survival was used to depict the pattern of death in 28 days and Cox-Proportional model was used to identify the predictors of the neonatal mortality.ResultsA total of 964 neonates which contributed to 5889 neonates-days were included in the study. There were 159 neonatal deaths during the follow-up time. Overall, the neonatal mortality incidence was 27 per 1000 neonates-days. Predictors of neonatal mortality were: multiple birth, mothers who did not attend antenatal care visits, neonates born by cesarean section, not initiated breast feeding within 1 h of birth, neonates resuscitated, hyaline membrane disease and perinatal asphyxia.ConclusionNeonatal mortality at neonatal intensive care unit was high. Managing neonatal complications, initiating breast feeding within 1 h of birth, promoting antenatal care visits, improving quality of services and ensuring continuum of care are recommended to increase survival of neonates.
Highlights
The first one month of life; the neonatal period is the most risky time for child survival
Neonates born from mothers who did not attend Antenatal care (ANC) visits during their pregnancy were six times at higher risk of death than neonates born from mothers who had ANC visits 4 and above AHR [95%Confidence interval (CI)] 6.02[3.52–10.27]
The multiple born neonates are at increased risk of prematurity and low birth weight, which may makes them susceptible to the risk of infection. The findings of this revealed that those neonates born from mothers who had no ANC visit had six times higher risk of neonatal mortality as compared to those who had four and above ANC visits
Summary
The first one month of life; the neonatal period is the most risky time for child survival. The world health organization reported 2.6 million deaths or roughly 46% of all under-five deaths occurred in 2016, up from 40% in 1990; neonatal mortality fell by 49% from 37 deaths per 1000 live births in 1990 to 19 in 2016 [1,2,3]. Congenital, preterm, neonatal sepsis and injury remain leading causes of death [6]. Several previous studies have identified a number of predictors that lead to neonatal deaths such as preterm birth (28%), sepsis (26%) and asphyxia (23%). Sepsis is the most common cause of neonatal mortality and is probably responsible for 30–50% of the total neonatal deaths each year [1, 7, 8]
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