Predictors of Survival Among Preterm Neonates Admitted to Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

BackgroundPre-maturity is the primary cause of neonatal mortality in the world. Although prematurity was the leading cause of neonatal mortality, the survival rate and its predictors may be varied from setting to setting and time to time due to different reasons. Therefore, this study aimed to assess the survival probability and predictors of mortality among preterm neonates at Felege Hiwot comprehensive specialized hospital.MethodsThis is a retrospective follow-up study that included 542 randomly selected preterm neonates admitted at Felege Hiwot comprehensive specialized hospital from the period of 2016-2020. Semi-parametric and parametric survival models were fitted to identify the survival probability of preterm neonates and its association with different predictors. The best fit model was selected using Akaike's information criteria, Bayesian information criteria and likelihood ratio criteria.ResultsThe cumulative incidence and incidence rate of mortality among preterm neonates were 31 per 100 live births and 3.5 per 100 neonate days, respectively. From the adjusted cox-proportional-hazard model, predictors with higher preterm mortality risk include the presence of neonatal respiratory distress syndrome [AHR = 2.55, 95% CI: 1.23; 3.74], perinatal asphyxia [AHR = 4.26, 95% CI: 1.35; 6.79] and jaundice [AHR = 3.25, 95% CI: 2.14, 7.24]. However, admission weight of 1,500–2,499 g (AHR = 0.23, 95% CI: 0.11, 0.56) and ≥2,500 g (AHR = 0.12, 95% CI: 0.02; 0.32), early breastfeeding [AHR = 0.44, 95% CI: 0.36; 0.48] and kangaroo mother care [AHR = 0.11, 95% CI: 0.03; 0.15] were protective factors of preterm mortality.ConclusionThe cumulative incidence of mortality among preterm neonates was consistent with the national incidence of preterm mortality. Factors such as respiratory distress syndrome, perinatal asphyxia, breastfeeding, kangaroo mother care, admission weight, and jaundice are significant predictors of survival. Therefore, considerable attention such as intensive phototherapy, optimal calorie feeding, oxygenation, and good thermal care should be given for admitted preterm neonates.

Escalating the limit of median survival time and predictors of mortality among preterm neonates in Northwest Ethiopia, 2021: a 1-year prospective follow-up study

“…On the other hand, the finding of this study is lower than that of the studies conducted in Bahir Dar, Ethiopia16 and Ghana 25. Moreover, in this finding is the median survival time is lower than the study conducted in Tigray region of Ethiopia,26 Bahir Dar, Ethiopia 27…”

“… 25 Moreover, in this finding is the median survival time is lower than the study conducted in Tigray region of Ethiopia, 26 Bahir Dar, Ethiopia. 27 …”

The incidence and factors predicting survival among preterm infants with respiratory distress syndrome admitted to neonatal intensive care unit

“…This might be possible because low birth weight preterm infants have low growth and immature organ development. This can increase complications and death (Belay et al, 2022). Therefore, birth weight of preterm infants with RDS could predict survival of preterm infants with RDS.…”

Incidence and Predictors of Preterm Mortality in Ethiopia: A Systematic Review and Meta-analysis

“…As described in Table 2, all the selected studies were published between 2015 and 2023. Eight studies were conducted in Amhara, 13,14,18,[23][24][25][26][27] three studies were in the Oromia, 16,17,20 and two studies were in Southern nations nationalities and peoples region, 21,28 In Addis Ababa, there were two studies, 15,19 and one study was in Tigray region 22 of Ethiopia. However, in terms of study design, two studies were prospective cohorts, while 14 studies 13,14,[16][17][18][19][20][21][22][23][24]26,27 were retrospective cohorts.…”

“…12 Generally, reports from studies done on preterm neonates treated at different health facilities in Ethiopia showed inconsistent preterm survival rates and its predictors. [13][14][15][22][23][24][25][26][27][28] Therefore, this study aimed to assess the pooled incidence of preterm mortality and its predictors among preterm neonates treated at different levels of health facilities in Ethiopia.…”