Predictors of neonatal mortality among neonates admitted to NICU at Dubti General hospital, Northeast Ethiopia

Abstract

Background: In Ethiopia, despite various strategies and interventions being implemented, the rate of neonatal mortality remains high. Despite numerous published articles in Ethiopia, there is a lack of sufficient data regarding the time to death and its predictors in neonatal mortality, especially in pastoral communities like the Afar region. Therefore, this study aims to evaluate neonatal mortality and its predictors among neonates admitted to the neonatal intensive care unit at Dubti General Hospital, Northeast Ethiopia.

Method: We conducted a facility-based retrospective follow-up study, involving a sample of 479 neonates admitted to the neonatal intensive care unit at Dubti General Hospital. Data entry was performed using Epi-Data version 4.6, and subsequent analysis was carried out using STATA version 14.1. To identify predictors of neonatal mortality, we applied the Cox-proportional hazard model.

Results: Out of the total, 87 neonates (18.16 %) passed away. The overall incidence of neonatal mortality was 27.2 deaths per 1000 neonate-days spent in the neonatal intensive care unit, with a 95 % confidence interval of [21.8, 34.2]. Appearance, pulse, grimace, activity, and respiration score less than or equal to 5 [AHR = 0.33, 95%CI: 0.07, 0.62], respiratory distress syndrome [AHR = 3.22, 95%CI: 1.71, 6.07], Neonatal hypothermia [AHR = 3.12, 95%CI: 1.31, 7.42]. No initiation of breastfeeding [AHR = 3.68, 95%CI: 1.44, 9.36], no antenatal care visits [AHR = 0.25, 95%CI: 0.13, 0.48] and maternal birth related complication [AHR = 2.71, 95%CI: 2.43, 11.14] are predictors.

Conclusion: The mortality rate was notably high, with several factors identified as independent predictors of newborn death, including Appearance, pulse, grimace, activity, and respiration, respiratory distress syndrome, hypothermia, initiation of breastfeeding, antenatal care visits, and maternal birth-related complications. There is a pressing need for intensified programming efforts aimed at improving child survival within healthcare facilities, particularly addressing neonatal complications. Enhancing prenatal care during pregnancy and early detection and treatment of intrapartum disorders are recommended strategies for enhancing newborn health outcomes.

Keywords: Neonatal mortality; Neonates; Northeast Ethiopia; Predictors.