Reasons for admission and neonatal outcome in the neonatal care unit of a tertiary care hospital in Addis Ababa: a prospective study

Abstract

Background:The neonatal mortality rate in Ethiopia remains greater than 35 per 1,000 live births. Hence, identifying the reasons for neonatal admission and mortality in a hospital setting is crucial to improve the quality of existing practices in the hospital. The objective of this study was to describe the reasons for admission and the magnitude of neonatal mortality in the neonatal care unit of St Paul's Hospital Millennium Medical College. Methods and subjects: A prospective cohort study was conducted. A total of 216 neonates who were admitted to the neonatal care unit of St Paul's Hospital Millennium Medical College from March 1, 2015, to May 31, 2015, were included in this study. Data fields, determined prospectively, were collected by monitoring the neonates until discharge or death. The independent variables were demographic, obstetric, and clinical characteristics, while the dependent variable was neonatal mortality. Data were analyzed using simple frequencies, odds ratio, and finally binary logistic regression analysis for mortality outcome. Results: The most common primary diagnoses at admission to the neonatal care unit were prematurity with respiratory problem (36.6%), neonatal sepsis (22.7%), and asphyxia (16.2%). Out of the 216 neonates studied, 50 (23.2%) died. High case fatality was observed among neonates with the diagnosis of prematurity with respiratory problem (40.5%) and asphyxia (40.0%). Under multivariate analysis, diagnosis of asphyxia was an independent predictor of mortality (adjusted odds ratio =5.817; 95% confidence interval: 1.611-20.977), while gestational age above the mean of the study population (36.6 weeks) was protective of mortality (adjusted odds ratio =0.683; 95% confidence interval: 0.588-0.795). Conclusion: Nearly a quarter of admitted neonates died. This study identified asphyxia and prematurity as major causes of admission and mortality. Emphasis has to be given to prevent asphyxia and to improve the survival of preterm babies.

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

“…On the other hand, the magnitude of NMR in the current study is lower as compared to the findings of the studies done at University of Gondar referral hospital-252 [30], Paul's Hospital Millennium Medical College Addis Ababa-232 [31], Pakistan Health Survey of 2014-680 [32] and University of Gondar comprehensive Specialized hospital (UoGCSH)-288 [33]. The variation in the magnitude of NMR could be secondary to the difference in the scope of the study.…”

“…The variation in the magnitude of NMR could be secondary to the difference in the scope of the study. It is observed that some other previous studies were conducted in a single centered institution which might have lacked representativeness unlike the current one [30,31,33]. The disparity also could be linked to discrepancy in sample size.…”

<p>Prevalence and Factors Associated with Neonatal Mortality at Ayder Comprehensive Specialized Hospital, Northern Ethiopia. A Cross-Sectional Study</p>

“…In the current study, males were higher in number 1069 (60%) at admission which is in agreement with studies done in Ethiopia, Gonder (58.3%), in St Paul's Hospital Millennium Medical College (61.1%) and other developing countries like South Africa (57.8%) India (63.3%) Pakistan (63%). 15,[19][20][21][22] The reasons could be due to cultural and societal factors in some society's male babies have more attention from caregivers than females. Male neonates also outnumbered females with respect to mortality (62.4%).…”

Proportion And Factors Of Death Among Preterm Neonates Admitted In Aksum University Compressive Specialized Hospital Neonatal Intensive Care Unit Northern Ethiopia 2019.

“…The odds of death were increased by nine times for a neonate with the first minute APGAR score < 7 at birth as compared to the counterpart with. The results were obtained from the Iran [24], Nigeria [25], Tikur Anbesa specialized hospital, Ethiopia [26], University of Gondar hospital. Ethiopia [7].…”