Neonatal Mortality and Associated Factors Among Neonates Admitted to the Neonatal Intensive Care Unit of Dil Chora Referral Hospital, Dire Dawa City, Ethiopia, 2021: A Facility-Based Study

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.

Predictors of neonatal mortality among neonates admitted to the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital, Sidama regional state, Ethiopia

“…Studies conducted in Hiwot Fana Specialized University Hospital, Eastern Ethiopia, at 14.3% infant mortality rates were found to be congruent with this 14.2% neonatal death magnitude [18];Jimma University Medical Center, Southwest Ethiopia at 13.3% [19] and Dire Dawa city, Ethiopia at11.4% [20].But the nding was lower compared with studies conducted in Ghana at 20.2% (17); Debre Markos, Northwest Ethiopia, at 21.3% (18); Mizan Tepi University Teaching Hospital, Southwest Ethiopia, at 22.8% (19); and Gondar Referral Hospital, Northwest Ethiopia, at 23.1% (13). However, the prevalence of neonatal death was much higher than studies conducted in the Somali Region, Ethiopia, at 5.7% (20); the North Gondar Zone, Ethiopia, at 4.4% (21); and the East Wollega Zone, Ethiopia, at 6.6% (22). The neonatal hospital mortality rate of 28 per 1000 neonates-days was highly consistent with a similar study done in Wolaita Sodo, Ethiopia, at 27 per 1000 neonates-days (23).…”

“…A data extraction checklist that was modi ed and adjusted from various literary works was used to review the medical records and collect the data [16,17]. The following variables were included in the data using the data collection tool: the clinical diagnosis at admission, sex, maternal and neonatal age, complications during pregnancy, gestational age, antenatal care visits, birth weight, place of birth (HUSCH, other, or home), the neonate's body temperature, random blood sugar at admission, the mode of delivery, the outcome (survival or death) at discharge, and the length of stay prior to discharge.…”

Risk factors and outcomes of intraoperative hypothermia in neonatal and infant patients undergoing general anesthesia and surgery

“…The adverse events of hypothermia are enormous such as thermal discomfort, alterations in pharmacokinetic and pharmacodynamic parameters (essentially muscle relaxants and opiates) ( 27 ), disruption of platelet function, coagulation ( 4 , 28 ) and blood loss, cardiocirculatory and respiratory complications, wound healing delay, and surgical site infections ( 29 ). In neonates and preterm infants, hypothermia can lead to pulmonary hypertension, tissue hypoxia, arterial hypotension and hypoperfusion of vital organs, metabolic acidosis, and hypoglycemia ( 30 ). All these may subsequently induce multiple pathophysiological changes such as catecholaminergic response, vasoconstriction, increased metabolism, and decreased surfactant synthesis ( 16 , 31 , 32 ).…”

Maternal Mental Health and Breastfeeding Support in Tertiary Hospital Nurseries in Nigeria

“…Concerning was the nding of an overall suboptimal level of breastfeeding support provided by healthcare workers to women whose babies were admitted to tertiary neonatal nurseries in Nigeria in all three support domains: breastfeeding, family, and technical. This is signi cant because mothers whose babies were admitted to level 2-4 healthcare facilities required more psychosocial support than mothers whose babies were admitted to lower-level healthcare facilities [58,59]. Nigeria adopted the WHO-approved Baby Friendly Hospital Initiative more than three decades ago, but implementation by healthcare workers remains suboptimal [15,16].…”