Neonatal Mortality and its Main Determinants in Premature Infants Hospitalized in Neonatal Intensive Care Unit in Fatemieh Hospital, Hamadan, Iran

Basiri, Behnaz; Ashari, Farzaneh Esna; Shokouhi, Maryam; Sabzehei, Mohammad Kazem

doi:10.17795/compreped-26965

Cited by 22 publications

(36 citation statements)

References 18 publications

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“…The current study finding showed that neonates with a very low birth weight experienced higher mortality. This finding is similar to studies conducted in Ethiopia and different parts of developing countries like Iran, Nigeria and Indonesia (4,15,52,61). The male predominance in this study is consistent with other studies done in Gonder; Sub Saharan Africa and Northern Ethiopia.…”

Section: Discussionsupporting

confidence: 92%

“…This study showed that there is higher rate of mortality than data extracted from HDSS in Kersa /eastern Ethiopia which was 19.55 per 1000 and other countries like Brazil (33,51,60).The discrepancy could be explained in terms of the place where information was gathered. Different studies conducted before in Sudan, Iran, China, Brazil, Cameroon, Indonesia and Ethiopia had revealed that most neonatal deaths occurred in the first 24hr and in the first week of life which is similar to this study (2,4,14,22,23,29,30,32,51,52).These findings could be associated with prematurity and low birth weight in which the NICU set up was impair to manage these risk factors during this period.…”

Section: Discussionsupporting

confidence: 88%

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Survival and predictors of early neonatal death in neonatal intensive care unit of Mekelle general and Ayder comprehensive specialized hospitals, Northern Ethiopia, 2018: prospective cohort study

Kahsay

Abebe

Gebretsadik

et al. 2019

Preprint

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Background: Early neonatal mortality refers to deaths of neonates between 0 and 6 days of life. This contributes three-quarters of neonatal deaths globally. Its predictors vary by country with the availability and quality of health care, which was chosen as the measure of mortality and remains a global public health concern especially in sub-Saharan African countries, including Ethiopia. So the aim of this study is to determine incidence, median survival time and to identify the predictors of early neonatal mortality.Methods: A prospective cohort study was conducted in Mekelle general and Ayder comprehensive specialized hospitals, Tigray, Ethiopia from January to March, 2018. Data were collected from 253 newborns admitted to the neonatal intensive care unit by interviewing mothers using structured questionnaires and followed for seven completed days of life (day 0 to 6).Kaplan Meier curves were used to estimate survival time, Log-rank test was used to look statistical differences among/between the categories of variables and Cox regression model was used to identify potential predictors of early neonatal deaths. The analysis was conducted using a computer program Stata version 12.Results: Overall, in this study 32 (12.65%) neonates died which makes the early neonatal mortality rate 126.5 per 1000 live births. The median survival time of early neonates was 2 days. Predictors of early neonatal mortality were very low birth weight (AHR= 3.02; 95 % CI: 1.11, 8.25) and preterm birth (AHR=3.7; 95 % CI: 1.22, 11.188). Conclusion: This study shows high incidences of early neonatal mortality. Very low birth weight and preterm birth were major predictors for early neonatal mortality. Managing complications of preterm and very low birth weight, preventing preterm delivery and improving quality of services and ensuring a continuum of care are recommended to increase survival of early neonate

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Survival and predictors of early neonatal death in neonatal intensive care unit of Mekelle general and Ayder comprehensive specialized hospitals, Northern Ethiopia, 2018: prospective cohort study

Kahsay

Abebe

Gebretsadik

et al. 2019

Preprint

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“…13 In this study mortality among extreme preterm infants was 74.2% and 42.4% in very preterm infants. The most significant predictor of death was gestational age regardless of the cause of death similar to studies done by Kong X et al, and Basiri et al 14,15 Mortality was 56.7% in babies less than 1000 gms which is comparable to National Neonatal Perinatal Database (NNPD) (55%) data and study by Cupen K et al 16 Studies done by Malik S et al, Baruah MN et al, and Katz et al, showed that small for gestational age was associated with increased risk of mortality. [17][18][19] The prevalence of Small for Gestational Age (SGA) in preterm infants less than 33 weeks was 9.6% as per National Neonatal Perinatal Data from intramural centres.…”

Section: Discussionsupporting

confidence: 79%

Mortality profile of extreme to very preterm infants in an extramural tertiary care neonatal unit of a teaching hospital in Southern India: a retrospective study

Shanmugam

Karthik

Muthukumaran

et al. 2020

Int J Contemp Pediatr

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Background: Neonatal deaths account for 47% of all deaths in children younger than 5 years globally. More than a third of deaths are due to preterm related complications. Understanding the factors contributing to preterm deaths and pattern of mortality is needed to implement interventions that are essential in improving neonatal survival.Methods: This was a retrospective study done in neonatal intensive care unit, Institute of Child Health (ICH) and Hospital for Children, Chennai, a tertiary care regional center. All preterm (<32 weeks) deaths registered in the neonatal medical records from 1st of January 2018 to 31st of December 2018 were analysed. Primary causes of deaths were analysed by two consultants. When there were more than one cause contributing to responsible for death the most significant problem was taken as the cause of death.Results: Overall neonatal mortality was 312 (14.2%) of 2189 neonates. Out of 148 admissions in the study population mortality was 74.2% (26 of 35) for extreme preterm (<28 weeks) infants and 42.7% (48 of 113) for very preterm (28 to 32 weeks) infants. Predominant causes of death were sepsis 44.5% (33), prematurity-related complications 37.8% (28) followed by congenital anomalies 12.1% (9) and miscellaneous causes 2.7% (2). Respiratory Distress Syndrome (RDS) and Intra Ventricular Haemorrhage (IVH) attributed to 75% (21/ 28) of deaths among prematurity-related complications.Conclusions: This study identified sepsis; prematurity related complications were the predominant causes of mortality in the extreme to very preterm population. Understanding the specific causes of preterm mortality would help to implement interventions to promote their survival.

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“…For example, in our study, from all neonates admitted due to respiratory distress syndrome, about 49% were premature. Different literature documented that respiratory distress syndrome is the most common cause of death among premature neonates [42,43].…”

Section: Discussionmentioning

confidence: 99%

Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study

et al. 2020

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Background: Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study area. Therefore, we conducted this prospective cohort study to determine the incidence and predictors of neonatal mortality at Debre Markos Referral Hospital, Northwest Ethiopia. Methods: This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality. Results: Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period (< 7 days post-partum). Using the multivariable Cox-regression analysis, being unemployed (AHR: 1.6, 95% CI: 1.01, 2.6), not attending ANC (AHR: 1.9, 95% CI: 1.01, 3.5), not initiating exclusive breastfeeding (AHR: 1.7, 95% CI: 1.02, 2.7), neonatal admission due to respiratory distress syndrome (AHR: 2.0, 95% CI: 1.3, 3.1), and first minute Apgar score classification of severe (AHR: 2.1, 95% CI: 1.1, 3.9) significantly increased the risk of neonatal mortality. Conclusion: In this study, we found a high rate of early neonatal mortality. Factors significantly linked with increased risk of neonatal mortality included: unemployed mothers, not attending ANC, not initiating exclusive breastfeeding, neonates admitted due to respiratory distress syndrome, and first minute Apgar score classified as severe.

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Neonatal Mortality and its Main Determinants in Premature Infants Hospitalized in Neonatal Intensive Care Unit in Fatemieh Hospital, Hamadan, Iran

Cited by 22 publications

References 18 publications

Survival and predictors of early neonatal death in neonatal intensive care unit of Mekelle general and Ayder comprehensive specialized hospitals, Northern Ethiopia, 2018: prospective cohort study

Survival and predictors of early neonatal death in neonatal intensive care unit of Mekelle general and Ayder comprehensive specialized hospitals, Northern Ethiopia, 2018: prospective cohort study

Mortality profile of extreme to very preterm infants in an extramural tertiary care neonatal unit of a teaching hospital in Southern India: a retrospective study

Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study

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