Survival status and predictors of mortality among asphyxiated neonates admitted to the NICU of Dessie comprehensive specialized hospital, Amhara region, Northeast Ethiopia

Abstract

Introduction Birth asphyxia is one of the leading causes of early neonatal mortality, which causes an estimated 900,000 deaths annually. Therefore, assessing the survival status and predictors of mortality among asphyxiated neonates will be highly helpful to policymakers in designing, implementing, and evaluating programs to achieve the sustainable development goal of reducing neonatal mortality as low as 12/1,000 live births by 2030. Methods A facility-based retrospective cohort study was conducted among 378 asphyxiated neonates admitted to the NICU of Dessie Comprehensive Specialized Hospital from January, 2017 –December, 2019. The data were collected from eligible records by using a structured data extraction tool from March 30 –April 21, 2020. The data were cleaned manually and entered into Epi-data version 7.1.2.0, and STATA version 16 was used for the analysis. Bivariate and Multivariate Cox proportional hazard regression analysis were performed, and significant predictors were identified using 95% confidence interval and p-value <0.05. Result A total of 378 neonates were followed for 2298 neonatal days, ranging from 1 to 28 days. The mortality incidence rate was 5.3/100 person-days-of observation (95% CI: 4.41, 6.29), and 32% (95% CI: 27.6%, 36.8%) of the study subjects died. Admission weight (AHR: 1.72; 95% CI: 1.09, 2.72), seizure (AHR: 1.52; 95% CI: 1.02, 2.27), neonates who received resuscitation (AHR: 2.11; 95% CI: 1.18, 3.80), and stage of asphyxia (moderate (AHR: 3.50; 95% CI: 1.55, 8.36), and severe (AHR: 11.55; 95% CI: 4.73, 28.25)) were significant predictors of neonatal mortality among asphyxiated neonates. Conclusion The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Admission weight, seizure, resuscitation, and stage of asphyxia were significant predictors of mortality among neonates with asphyxia. Therefore, special attention should be given to asphyxiated neonates with low admission weight and those who had seizure. Additionally, the timing, quality, and effectiveness of resuscitation might need further assessment and evaluation.

Time to death and predictors of mortality among asphyxiated neonates in southwest Ethiopia, 2022: prospective cohort study

“…After reviewing the literature,11 13–16 the tool was adapted and prepared in English and translated into the local language Amharic, and retranslated back into English. Data were collected through face-to-face interviews with the mother and day-to-day neonatal follow-up with a neonatal chart (ie, from the time of admission to 28 days of neonatal age).…”

Incidence and predictors of mortality among neonates admitted with birth asphyxia to neonatal intensive care unit of West Shewa Zone Public Hospitals, Central Ethiopia

“…Censored: Newborns with birth asphyxia who did not develop the outcome of interest (death) until the end of the follow-up period, recovered from illness, discharged against medical advice or transferred out to other health institutions without knowing the outcome. 15 …”

Multiorgan dysfunction in birth asphyxia

“…The Apgar score at five (5) minutes, particularly the change in score between one (1) minute and five (5) minutes, serves as a valuable indicator for evaluating the effectiveness of resuscitation efforts and predicting the risk of organ dysfunction, prognosis for survival, and sequelae in neonates [13]. A lower Apgar score at five (5) minutes indicates a higher likelihood of long-term hypoxia and subsequent organ damage.…”