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Predictors, causes, and trends of neonatal mortality at Nekemte Referral Hospital, east Wollega Zone, western Ethiopia (2010–2014). Retrospective cohort study


Autoři: Elias Merdassa Roro aff001;  Meseret Itana Tumtu aff001;  Dejene Seyoum Gebre aff001
Působiště autorů: Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia aff001;  Nekemte Polly Clinic, Nekemte Town, Oromia, Ethiopia aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0221513

Souhrn

Background

Neonatal mortality is a significant contributor to infant mortality. Causes and predictors of neonatal death are known to vary in different settings and across different contexts. This study aimed to assess predictors, causes, and trends of neonatal mortality amongst neonates admitted to Nekemte Referral Hospital neonatal unit between 2010–2014.

Methods

Retrospective data was collected for 2090 live born neonates admitted to the neonatal intensive care unit of Nekemte Referral Hospital by reviewing records between 2010 to 2014. Variables were collected from the neonatal registration book and patient card on the predictors, causes, and trends of neonatal death using a standard checklist developed by the World Health Organization (WHO). Data was analyzed using Epi info version 3.5.1, and SPSS version 25 for windows. The level of significance was set at P<0.05 with the corresponding confidence intervals at 95%. A logistic regression model was used for analysis and to control for confounders. Microsoft Excel 2007 was used to construct the trend analysis.

Results

There were 183 deaths in the cohort equivalent to 8.8% of deaths among total admitted neonates during the study period. Early neonatal deaths accounted for 8% and late neonatal deaths accounted for 0.71% of deaths among total admitted neonates. Main predictors identified for an increased risk of neonatal mortality were; neonates from rural residents [AOR 1.35, (95% CI, 1.35–1.87)], birth order of greater than five [AOR 5.10, (95% CI, 1.15–22.63)], home delivery [AOR 3.41, (95% CI, 2.24–5.19)], very low birth weight [AOR 6.75, (95% CI, 3.63–12.54)] and low birth weight [AOR 2.81, (95% CI, 1.95–4.05)] and inability to cry at birth [AOR 2.21, (95% CI, 1.51–3.22)]. The trend analysis showed a sharp fall for the neonatal mortality over the last five years with a mean reduction of 16%.

Conclusions

Data from the Nekemte Referral Hospital Neonatal Intensive Care Unit analysis revealed majority of the deaths were occurred during early neonatal period. The main predictors of neonatal mortality identified from this study needs strengthening an appropriate public health intervention through addressing antenatal care, curbing home delivery.

Klíčová slova:

Antenatal care – Birth weight – Death rates – Child health – Labor and delivery – Neonatal care – Neonatal sepsis – Neonates


Zdroje

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