Incidence and predictors of neonatal mortality among neonates admitted in Amhara regional state referral hospitals, Ethiopia: prospective follow up study

Abstract

Background: Globally, about 2.7 million neonates die annually and more than 99% of these deaths happened in developing countries. Although most neonatal deaths are preventable and attempts had been taken to tackle these deaths, an aggregate of 30 neonatal deaths per 1000 live births had been reported in Ethiopia. In this regard, identifying the predictors could be an important step. However, evidence on the incidence and predictors of neonatal mortality has been limited in Ethiopia, in the study area in particular. Even the available studies were limited in scope and were retrospective or cross section in nature. Thus, this study is aimed at assessing the incidence and predictors of neonatal mortality among neonates admitted in Amhara regional state referral hospitals, Ethiopia.. Method: A multi center prospective follow up study was conducted on 612 neonates admitted in Amhara region referral hospitals from July 01 to August 30, 2018. A simple random sampling technique was used to select three of all referral hospitals in the study settings and all neonates admitted in the selected hospitals were included. Data were entered into Epi info version 7.0 and exported to STATA 14.0 for analysis. Cox proportional hazard regression model was fitted to identify predictors of neonatal mortality. Crude and Adjusted hazard ratio with 95% confidence interval was computed and variables' statistical significance was declared based on its AHR with 95% CI and p-value ≤0.05.Result: Overall, 144 (18.6%) neonates died with a total person-time of 4177.803 neonate-days which is equivalent to the neonatal mortality rate of 186 per 1000 admitted neonates with 95% CI (157,219). The incidence rate of neonatal mortality was 27 per 1000 admitted neonates with 95%CI (23, 33). Maternal age ≥ 35 years (AHR = 2.60; 95%CI: 1.44, 4.72), mothers unable to read and write (AHR = 1.40; 95%CI: 1.23, 2.44), multiple pregnancy (AHR = 3.96; 95%CI: 2.10, 7.43) and positive maternal HIV status (AHR = 6.57; 95%CI: 2.53, 17.06) were predictors of neonatal mortality.(Continued on next page)

Survival and Predictors of Mortality Among Neonates Admitted to Neonatal Intensive Care Unit at Bombe Primary Hospital, Southern Ethiopia: Institution-Based Retrospective Cohort Study

“…The overall incidence rate of neonatal mortality was 20.8 deaths per 1000 neonates which is lower than the reports of the study conducted by 13 , 17 , 18 and (Gudayu et al, 2020). However, higher than the results reported by.…”

“…Almost 95% of the neonatal deaths occurred in the first 1 week of life consistent with studies conducted at Gondar Comprehensive Specialized, 25 and in Amhara region referral hospitals. 18 Evidences indicate in Ethiopia that more than three-quarter of neonatal mortality occurred in the first six days of life 13 , 20 , 26 , 27 which could be related to the conditions of labor, intra-partum and the immediate newborn care practices.…”

Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis

“…This meta-analysis included 32 different studies covering a total of 21,405 preterms. The studies were conducted from 2012 to 2020 among more than 11 Eastern Africa countries including 12 from Ethiopia represented by 14 studies [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Tanzania [ 14 , 45 , 46 , 47 ] and Uganda [ 12 , 48 , 49 , 50 ] represented by 04 studies, Besides, Burundi [ 51 , 52 ] and Eretria [ 53 , 54 ] represented by 02 studies.…”

Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…Similarly, the predictors of time to NM were reported by seven [ 11 , 23 , 25 – 27 , 29 , 30 ] community-based studies, studies conducted through the analysis of secondary data obtained from demographic and health surveys. Regarding the quality scores of articles, nine [ 11 , 15 – 21 , 23 ], eight [ 12 , 14 , 22 , 24 – 26 , 28 , 30 ], and three [ 13 , 27 , 29 ] were classified under high, medium, and low qualities, respectively.…”

“…Likewise, the pooled IDR of LNM (0.92 per1000 neonate-days; 95% CI: 0.62, 1.22; I 2 = 96.3%, p ≤ 0.001) was computed using 10 eligible articles. Of these, the IDR of LNM in NICU was 5.09 per 1000 neonate-days (95% CI: 2.52, 7.65; I 2 = 94.9%, p ≤ 0.001) that was computed from seven eligible studies [ 12 , 16 – 21 ]. The IDR of LNM in the community [ 11 , 23 , 24 ] was found to be 0.31 per 1000 neonate-days (95% CI: 0.08, 0.55; I 2 = 97.8%, p ≤ 0.001) ( Figure 3 ).…”