Time to death and its predictors among early neonatal patients in neonatal intensive care unit of Dessie referral hospital, South Wollo Zone, Northeast Ethiopia

Yonas Fissha Adem, Yosef Haile, Moges Milashu
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Abstract

Background: Early neonatal death is a serious concern, both in the developing and developed worlds. Early neonatal death remains a health problem and is the biggest component of the neonatal mortality rate. Therefore, substantial reduction in early neonatal mortality is a crucial pre-requisite for achieving further gains in child survival in the country. However, the distribution of deaths in the community within the first week is poorly understood. Therefore, this study was conducted to assess time to death and its predictors among early neonates in the neonatal intensive care unit of Dessie Referral Hospital. Method: A retrospective cohort study was conducted in the early neonatal patient in Dessie referral hospital on the total sample size of 416 selected patients by using a simple random sampling technique. Data were collected by document review. Life table used to estimate the probability of survival, log-rank test to compare survival in two or more groups and the Cox proportional hazard model was used to determine factors associated with time to death of early neonate. The hazard ratio with 95% confidence level was used to declare statistical significant association. Result: A total of 416 early neonates were included in the study. There were 224(53.8%) male neonates. The overall early neonatal mortalities were 47(11.3%), of which 23.41% of them died on the first day of age. early neonatal mortality was associated with neonatal sepsis (AHR=3.349,95% CI,1.842-6.089), low birth weight of neonates (AHR=3.563%,95% CI,1.925-6.595), unable to breastfeeding during delivery (AHR=4.094,95% CI,1.603-10.452), neonatal respiratory distress (AHR=4.018,95% CI,1.733-9.371), perinatal asphyxia (AHR =2.540,95% CI,1.186-5.847). Conclusion: The causes of early neonatal death described in this study were preventable. Managing low birth weight, initiating exclusive breastfeeding, refining quality of service, and confirming the continuity of care are recommended to increase the survival of neonates.
埃塞俄比亚东北部南沃罗区Dessie转诊医院新生儿重症监护室早期新生儿患者的死亡时间及其预测因素
背景:无论是在发展中国家还是发达国家,新生儿早期死亡都是一个令人严重关切的问题。新生儿早期死亡仍然是一个健康问题,是新生儿死亡率的最大组成部分。因此,大幅降低早期新生儿死亡率是该国进一步提高儿童存活率的关键先决条件。然而,人们对第一周内社区内的死亡分布知之甚少。因此,本研究旨在评估Dessie转诊医院新生儿重症监护室早期新生儿的死亡时间及其预测因素。方法:采用简单随机抽样的方法,对Dessie转诊医院的早期新生儿患者进行回顾性队列研究,总样本量为416例。通过文献回顾收集资料。生命表用于估计生存概率,log-rank检验用于比较两组或两组以上的生存,Cox比例风险模型用于确定与早期新生儿死亡时间相关的因素。采用95%置信水平的风险比来宣布统计学上显著的相关性。结果:共纳入416例早期新生儿。男婴224例(53.8%)。新生儿早期总死亡率为47例(11.3%),其中23.41%在出生后第一天死亡。新生儿早期死亡率与新生儿败血症(AHR=3.349,95% CI,1.842-6.089)、新生儿低出生体重(AHR=3.563%,95% CI,1.925-6.595)、分娩时不能母乳喂养(AHR=4.094,95% CI,1.603-10.452)、新生儿呼吸窘迫(AHR=4.018,95% CI,1.733-9.371)、围产期窒息(AHR= 2.540,95% CI,1.186-5.847)相关。结论:本研究描述的早期新生儿死亡原因是可以预防的。建议管理低出生体重,开始纯母乳喂养,提高服务质量,并确认护理的连续性,以提高新生儿的存活率。
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