INCIDENCE AND PREDICTORS OF NEONATAL MORTALITY AMONG NEONATES ADMITTED WITH PERINATAL ASPHYXIA AT ASELLA REFERRAL AND TEACHING HOSPITAL, ETHIOPIA: A RETROSPECTIVE COHORT STUDY, 2024

Abstract

ABSTRACT Introduction Perinatal asphyxia is a preventable and treatable cause of newborn death, yet it remains the third leading cause of death among children under one month. It can have both short- and long-term neurodevelopmental consequences, including impairment or death. Despite advancements in management, perinatal asphyxia remains a significant public health issue, particularly in developing countries like Ethiopia. Adequate data on death rates and associated determinants are crucial due to the underreported comorbidities. Objectives To assess the incidence and predictors of mortality among neonates with perinatal asphyxia admitted to the neonatal intensive care unit at Asella Referral and Teaching Hospital, Oromia, Ethiopia, in 2024. Methods and Materials A five-year retrospective cohort study was conducted from January 1, 2020, to September 31, 2024. A simple random sampling technique was used to select 354 neonates’ charts who met the inclusion criteria. The data were exported to SPSS for analysis, applying both descriptive and inferential statistics to address the study objectives. Results During the follow-up period, the overall incidence of mortality was 54 per 1000 person-days observation (95% CI: 44.4 to 63.7). The proportion of death was 120 neonates (33.9%) died. Several factors were identified as significant predictors of mortality, including Hypoxic-Ischemic Encephalopathy (HIE) Stage III, ARR = 1.526, 95% CI: (1.387-1.680), and HIE stage II, ARR = 1.488, 95% CI: (1.363-1.625), Age of neonates b/n 30-to-60 minutes at admission ARR = 1.110, 95% CI: (1.033-1.186), Non vertex-fetal presentation ARR = 1.069, 95% CI: (1.013-1.128), History of use of CPAP, ARR = 0.905, 95% CI: (.813-0.999), and History of Hypoglycemia ARR = 0.773, 95% CI: (0.628-0.950). There were significant predictors of mortality among neonates with perinatal asphyxia. Conclusion and Recommendation: The study found that the neonatal mortality among neonates admitted with perinatal asphyxia remains high, advanced stages of HIE, Age of neonates at admission, Fetal presentation, History of use of CPAP, and History of Hypoglycemia were independent predictors of mortality. Early identification of high-risk pregnancies and timely interventions could help reduce neonatal deaths due to perinatal asphyxia. Keywords: Perinatal asphyxia, Incidence, Predictors, Mortality