Speciality in Pediatrics and Child Health

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Browsing Speciality in Pediatrics and Child Health by Author "TEMESGEN REGASSA"

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    MORTALITY AND ITS PREDICTORS AMONG PRETERM NEONATES ADMITTED AT ASELLA TEACHING AND REFERRAL HOSPITAL
    (2025-05-01) TEMESGEN REGASSA
    Abstract Background: Preterm birth, defined as the birth of a baby before 37 completed weeks of gestation, remains a major public health concern worldwide, particularly in low- and middle-income countries. It is a leading cause of neonatal morbidity and mortality, contributing significantly to under-five deaths. In Ethiopia, preterm birth is a major contributor to neonatal mortality, despite ongoing efforts to improve maternal and neonatal health services. Understanding the outcome and underlying predictors of mortality in this vulnerable population is critical for developing targeted interventions and improving survival rates. Objectives: To Assess Mortality and its predictors among preterm neonates at Asella teaching and referral hospital from April 2022 to March 2025. Methods: A Hospital based retrospective cohort study was conducted on preterm neonates admitted to neonatal intensive care unit of Asella teaching and referral hospital. A sample of 304 preterm neonatal records was included in the study. Data was collected from the medical records of neonates using a customized KOBO Toolbox based data collection form. Data was exported,coded and analyzed using SPSS version 26. Descriptive analysis was carried out to describe patient’s baseline characteristics and was summarized as frequencies, proportions, means, and SD. A descriptive survival time analysis using the duration of illness from birth until the event was carried out and Kaplan-Meier survival estimates was computed. Results: In this study, out of 304 recorded cases, 302 neonates were included, resulting in a response rate of 99.3%. Of the 302 preterm neonates that were included, 22.8% died (95% CI: 18.0–28.1) or 22.5 deaths per 1,000 neonate-day. Among those who died, the mean survival time was 19.78 days (95% CI: 18.26–21.31). Significant predictors of mortality were gestational age <32 weeks (AHR = 6.56; 95% CI: 3.66–11.77), delivery at other health facilities (AHR = 2.46; 95% CI: 1.45–4.18), lack of Kangaroo Mother Care (AHR = 4.04; 95% CI: 2.22–7.34), and thrombocytopenia (AHR = 2.13; 95% CI: 1.22–3.71). Conclusion and recommendation: Preterm neonatal mortality remains high in the study area, with an incidence of 22.8% or 22.5 deaths per 1,000 neonate-day and a mean survival time of 19.78 days. Key predictors include extreme prematurity, delivery at other facilities, lack of Kangaroo Mother Care, and thrombocytopenia. It is recommended that the concerned bodies strengthen neonatal care units, implement standardized Kangaroo Mother Care, and ensure early detection and management of thrombocytopenia. Strengthening referral systems and improving perinatal care quality has also paramount importance. Key words: preterm, mortality, predictors.