Determinants of early neonatal mortality (hospital based retrospective cohort study in Somali region of Ethiopia)

Abstract

Early neonatal mortality occurs when a newborn dies within the first seven days of life. Despite interventions, neonatal mortality remains public health problem over time in Ethiopia (33 per 1000 live births). Determinants varies on level of neonatal mortality. The study's goal was to determine magnitude of early newborn death, as well as its determinants and causes in Newborn Intensive Care Unit of Referral hospital in Ethiopia's Somali region. Health facility based retrospective study review was conducted between May 2019 to May 2021 in Shiek Hassan Yabare Referral Hospital of Jigjiga University of Ethiopia. All neonates admitted at neonatal intensive care unit (NICU) with complete data and get registered using the new NICU registration book from May 2019 to May 2021 were included. Kobo toolkit was used for data collection and analyzed in SPSS 20. The magnitude of early neonatal mortality rate was defined as death between 0 and 7 days. Logistic regression model was used to estimate maternal and neonatal characteristics as a determinant variables on neonatal mortality. The statistical significance was considered at P-value < 0.05. The magnitude of early neonatal mortality rate of Ethiopia’s Somali region is estimated to be 130 per 1000 live births—that is say 130 newborn couldn’t celebrate their seventh day in every 1000 live births. Hypothermia, prematurity, maternal death at birth and shorter length of stay in NICU were increasing the chance of neonatal mortality at early stage while neonatal resuscitation had shown protective effect against neonatal mortality. Similarly birth asphyxia, preterm, sepsis, and congenital abnormalities were major causes of admission and death in the NICU. The magnitude of early neonatal mortality is considerable and most of the determinants are preventable. Enhancing quality of intra-partum and NICU care including infection prevention, managing hypothermia and neonatal resuscitation as per the national standard within the first golden hour is key.

Burden of early neonatal mortality in Sub-Saharan Africa. A systematic review and meta-analysis

“…The remaining 40 studies’ whole texts were read in their entirety. The 14 studies that satisfied the inclusion criteria were included in this systematic review and meta-analysis [ 5 , 8 , 17 – 28 ] ( Fig 1 ).…”

Predictors of perinatal mortality in the seven major hospitals of Lusaka Zambia: A Case Control Study

“…Factors that contribute to macerated stillbirths include intrauterine growth restriction, infections, and placental lesions, while a large proportion of these deaths remains unexplained (25). Early neonatal deaths also tend to be more because their attributed risk to mortality are a mix of low birthweight, complications that need neonatal intensive care and maternal complications (26, 27). Birth asphyxia, sepsis, prematurity, respiratory illnesses, and other unspecified illnesses have also been reported as the major risks of early neonatal death according to a study done in Ethiopia (28).…”

Newborn Care Service Utilization and Associated Factors among Women who gave birth in Kore District, West Arsi Zone, Ethiopia, 2022. A mixed method study

“…A similar number of babies are still born and 99% of all neonatal deaths occur in low and middle-income countries (9,10). The neonatal period is the period from birth to the rst 28 days of life, is the most critical phase of life in which the risk for death is the highest and therefore needs more attention and care (3,11). Globally there is strong and growing evidence of inequities in maternal and newborn health (2).…”

“…Breastfeeding, new-born resuscitation, kangaroo mother care' for premature babies (prolonged skin-toskin contact with the mother), and preventing and treating infections are the most effective interventions in life-saving of the newborn in Ethiopia and implementing the key neonatal and child survival interventions (1,6,9,20,24). Furthermore, care seeking for common illnesses and utilization of clinical services such as skilled attendance, post-natal care, and treatment for common illnesses including pneumonia, diarrhea, malaria, and sepsis management remains low (1,6,11,25). Maternity care, Integrated Maternal Newborn and Childhood Illness (IMNCI), and essential newborn care are key components of services provided at the health centers and the HEWs providing preventive and promotive care including treatment of severe acute malnutrition, malaria, and diarrhea (12,14,22).…”