Abstract
ObjectiveNeonatal mortality accounts for 43% of under-five child mortality in Ethiopia where preterm is the second leading cause of neonatal death and steadily increased in low-income countries. Therefore, assessing the proportion of death and associated factors among preterm neonates has a paramount importance in designing an effective strategy to intervene and achieve sustainable development goal.ResultsIn this study proportion of preterm neonatal death in this study was 28.8% [95% CI (25.1, 32.9)]. Complications during index pregnancy [AOR = 1.92, 95% CI (1.09, 3.38)], gestational age [AOR = 0.78, 95% CI (0.69, 0.91)], small for gestational age [AOR = 2.42, 95% CI (1.33, 4.38)], APGAR score at birth < 7 [AOR = 2.39, 95% CI (1.34, 4.27)], hyaline membrane disease [AOR = 5.15, 95% CI (2.83, 9.36)], neonatal respiratory distress at admission [AOR = 1.93, 95% CI (1.13, 3.31)], presence of jaundice [AOR = (3.39, 95% CI (1.90, 6.05)], received kangaroo mother care [AOR = 0.13, 95% CI (0.05, 0.35)], and hypoglycemia at admission [AOR = 3.86, 95% CI (2.12, 7.06)] were statistically significant. The proportion of preterm neonatal death was high. Ministry of health and responsible organizations should give special attention for preterm neonates to prevent life-threatening complications.
Highlights
In the globe, approximately 3.1 million and 2.9 million neonatal deaths were reported in 2010 and 2014, respectively, which accountings 40% of the under 5 mortality
Complications during index pregnancy [adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI) (1.09, 3.38)], gestational age [AOR = 0.78, 95% CI (0.69, 0.91)], small for gestational age [AOR = 2.42, 95% CI (1.33, 4.38)], Appearance Pulse Grimace Activity Respiration (APGAR) score at birth < 7 [AOR = 2.39, 95% CI (1.34, 4.27)], hyaline membrane disease [AOR = 5.15, 95% CI (2.83, 9.36)], neonatal respiratory distress at admission [AOR = 1.93, 95% CI (1.13, 3.31)], presence of jaundice [AOR = (3.39, 95% CI (1.90, 6.05)], received kangaroo mother care [AOR = 0.13, 95% CI (0.05, 0.35)], and hypoglycemia at admission [AOR = 3.86, 95% CI (2.12, 7.06)] were statistically significant
Findings from bivariate analysis showed that complications during index pregnancy, previous bad obstetric history, neonatal respiratory distress, gestational age, small for gestational age, low APGAR score at birth, hyaline membrane disease (HMD), perinatal asphyxia (PNA), jaundice, receiving kangaroo mother care (KMC), hypoglycemia, hypothermia, and temperature within 1 h of admission in °C were significantly associated with death of preterm neonates
Summary
Approximately 3.1 million and 2.9 million neonatal deaths were reported in 2010 and 2014, respectively, which accountings 40% of the under 5 mortality. 3 in 4 neonatal deaths were caused by preterm birth complications which accounts for 35% of all neonatal deaths [3]. Infection (36%), preterm birth (28%) and birth asphyxia (23%) are the most common causes of neonatal mortality in the world [4–6]. Preterm (PT), a birth before 37 completed weeks of gestation, is the most frequent cause of neonatal death. Ethiopian Demographic and Health Surveys reported that neonatal death was increased from 32% in 2005 to 43% in the 2016 and according to United Nations Children’s Fund (UNICEF) report, preterm birth which accounts 23% was believed to be a major and direct cause of neonatal death in Ethiopia [9, 10]. Causal factors linked to preterm birth are medical conditions of the mother or fetus, genetic influences, environmental exposure, infertility treatments, behavioral and socio-economic factors, medically indicated preterm delivery as well as iatrogenic prematurity [11, 12]
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