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Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study
Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study...
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| Published in: | BMC pediatrics 2020-02, Vol.20 (1), p.72-11, Article 72 |
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| creator | Alebel, Animut Wagnew, Fasil Petrucka, Pammla Tesema, Cheru Moges, Nurilign Abebe Ketema, Daniel Bekele Yismaw, Lieltework Melkamu, Mamaru Wubale Hibstie, Yitbarek Tenaw Temesgen, Belisty Bitew, Zebenay Workneh Tadesse, Animen Ayehu Kibret, Getiye Dejenu |
| description | Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study area. Therefore, we conducted this prospective cohort study to determine the incidence and predictors of neonatal mortality at Debre Markos Referral Hospital, Northwest Ethiopia.
This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality.
Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period ( |
| doi_str_mv | 10.1186/s12887-020-1963-z |
| format | article |
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This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality.
Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period (< 7 days post-partum). Using the multivariable Cox-regression analysis, being unemployed (AHR: 1.6, 95% CI: 1.01, 2.6), not attending ANC (AHR: 1.9, 95% CI: 1.01, 3.5), not initiating exclusive breastfeeding (AHR: 1.7, 95% CI: 1.02, 2.7), neonatal admission due to respiratory distress syndrome (AHR: 2.0, 95% CI: 1.3, 3.1), and first minute Apgar score classification of severe (AHR: 2.1, 95% CI: 1.1, 3.9) significantly increased the risk of neonatal mortality.
In this study, we found a high rate of early neonatal mortality. Factors significantly linked with increased risk of neonatal mortality included: unemployed mothers, not attending ANC, not initiating exclusive breastfeeding, neonates admitted due to respiratory distress syndrome, and first minute Apgar score classified as severe.</description><identifier>ISSN: 1471-2431</identifier><identifier>EISSN: 1471-2431</identifier><identifier>DOI: 10.1186/s12887-020-1963-z</identifier><identifier>PMID: 32061260</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Age ; Apgar score ; Birth weight ; Births ; Breast feeding ; Breastfeeding & lactation ; Cesarean Section ; Cohort analysis ; Cohort Studies ; Debre Markos referral hospital ; Ethiopia - epidemiology ; Family physicians ; Female ; Hospitals ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Intensive care ; Intensive Care Units, Neonatal ; Low income groups ; Male ; Medical referrals ; Mortality ; Mothers ; Neonatal care ; Neonatal intensive care ; Neonatal intensive care unit ; Neonatal mortality ; Newborn babies ; Newborn infants ; Northwest Ethiopia ; Obstetrics ; Patient outcomes ; Pregnancy ; Prenatal care ; Prospective Studies ; Public health ; Public health movements ; Questionnaires ; Referral and Consultation ; Regression analysis ; Respiratory distress syndrome ; Retrospective Studies ; Risk Factors ; Survival analysis ; Time ; Variables</subject><ispartof>BMC pediatrics, 2020-02, Vol.20 (1), p.72-11, Article 72</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c591t-a05b2f1c4e6ea1f1ad66aa1a5b34ba8aa9e6134a313ab914a4fed97d2d90021f3</citedby><cites>FETCH-LOGICAL-c591t-a05b2f1c4e6ea1f1ad66aa1a5b34ba8aa9e6134a313ab914a4fed97d2d90021f3</cites><orcidid>0000-0003-2822-2062</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023807/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2357507083?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32061260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alebel, Animut</creatorcontrib><creatorcontrib>Wagnew, Fasil</creatorcontrib><creatorcontrib>Petrucka, Pammla</creatorcontrib><creatorcontrib>Tesema, Cheru</creatorcontrib><creatorcontrib>Moges, Nurilign Abebe</creatorcontrib><creatorcontrib>Ketema, Daniel Bekele</creatorcontrib><creatorcontrib>Yismaw, Lieltework</creatorcontrib><creatorcontrib>Melkamu, Mamaru Wubale</creatorcontrib><creatorcontrib>Hibstie, Yitbarek Tenaw</creatorcontrib><creatorcontrib>Temesgen, Belisty</creatorcontrib><creatorcontrib>Bitew, Zebenay Workneh</creatorcontrib><creatorcontrib>Tadesse, Animen Ayehu</creatorcontrib><creatorcontrib>Kibret, Getiye Dejenu</creatorcontrib><title>Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study</title><title>BMC pediatrics</title><addtitle>BMC Pediatr</addtitle><description>Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study area. Therefore, we conducted this prospective cohort study to determine the incidence and predictors of neonatal mortality at Debre Markos Referral Hospital, Northwest Ethiopia.
This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality.
Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period (< 7 days post-partum). Using the multivariable Cox-regression analysis, being unemployed (AHR: 1.6, 95% CI: 1.01, 2.6), not attending ANC (AHR: 1.9, 95% CI: 1.01, 3.5), not initiating exclusive breastfeeding (AHR: 1.7, 95% CI: 1.02, 2.7), neonatal admission due to respiratory distress syndrome (AHR: 2.0, 95% CI: 1.3, 3.1), and first minute Apgar score classification of severe (AHR: 2.1, 95% CI: 1.1, 3.9) significantly increased the risk of neonatal mortality.
In this study, we found a high rate of early neonatal mortality. Factors significantly linked with increased risk of neonatal mortality included: unemployed mothers, not attending ANC, not initiating exclusive breastfeeding, neonates admitted due to respiratory distress syndrome, and first minute Apgar score classified as severe.</description><subject>Age</subject><subject>Apgar score</subject><subject>Birth weight</subject><subject>Births</subject><subject>Breast feeding</subject><subject>Breastfeeding & lactation</subject><subject>Cesarean Section</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Debre Markos referral hospital</subject><subject>Ethiopia - epidemiology</subject><subject>Family physicians</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>Intensive Care Units, Neonatal</subject><subject>Low income groups</subject><subject>Male</subject><subject>Medical referrals</subject><subject>Mortality</subject><subject>Mothers</subject><subject>Neonatal care</subject><subject>Neonatal intensive care</subject><subject>Neonatal intensive care unit</subject><subject>Neonatal mortality</subject><subject>Newborn babies</subject><subject>Newborn infants</subject><subject>Northwest Ethiopia</subject><subject>Obstetrics</subject><subject>Patient outcomes</subject><subject>Pregnancy</subject><subject>Prenatal care</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Public health movements</subject><subject>Questionnaires</subject><subject>Referral and Consultation</subject><subject>Regression analysis</subject><subject>Respiratory distress syndrome</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival 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; Tesema, Cheru ; Moges, Nurilign Abebe ; Ketema, Daniel Bekele ; Yismaw, Lieltework ; Melkamu, Mamaru Wubale ; Hibstie, Yitbarek Tenaw ; Temesgen, Belisty ; Bitew, Zebenay Workneh ; Tadesse, Animen Ayehu ; Kibret, Getiye Dejenu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c591t-a05b2f1c4e6ea1f1ad66aa1a5b34ba8aa9e6134a313ab914a4fed97d2d90021f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Apgar score</topic><topic>Birth weight</topic><topic>Births</topic><topic>Breast feeding</topic><topic>Breastfeeding & lactation</topic><topic>Cesarean Section</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Debre Markos referral hospital</topic><topic>Ethiopia - epidemiology</topic><topic>Family physicians</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant 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Mamaru Wubale</au><au>Hibstie, Yitbarek Tenaw</au><au>Temesgen, Belisty</au><au>Bitew, Zebenay Workneh</au><au>Tadesse, Animen Ayehu</au><au>Kibret, Getiye Dejenu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study</atitle><jtitle>BMC pediatrics</jtitle><addtitle>BMC Pediatr</addtitle><date>2020-02-15</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>72</spage><epage>11</epage><pages>72-11</pages><artnum>72</artnum><issn>1471-2431</issn><eissn>1471-2431</eissn><abstract>Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study area. Therefore, we conducted this prospective cohort study to determine the incidence and predictors of neonatal mortality at Debre Markos Referral Hospital, Northwest Ethiopia.
This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality.
Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period (< 7 days post-partum). Using the multivariable Cox-regression analysis, being unemployed (AHR: 1.6, 95% CI: 1.01, 2.6), not attending ANC (AHR: 1.9, 95% CI: 1.01, 3.5), not initiating exclusive breastfeeding (AHR: 1.7, 95% CI: 1.02, 2.7), neonatal admission due to respiratory distress syndrome (AHR: 2.0, 95% CI: 1.3, 3.1), and first minute Apgar score classification of severe (AHR: 2.1, 95% CI: 1.1, 3.9) significantly increased the risk of neonatal mortality.
In this study, we found a high rate of early neonatal mortality. Factors significantly linked with increased risk of neonatal mortality included: unemployed mothers, not attending ANC, not initiating exclusive breastfeeding, neonates admitted due to respiratory distress syndrome, and first minute Apgar score classified as severe.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32061260</pmid><doi>10.1186/s12887-020-1963-z</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2822-2062</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1471-2431 |
| ispartof | BMC pediatrics, 2020-02, Vol.20 (1), p.72-11, Article 72 |
| issn | 1471-2431 1471-2431 |
| language | eng |
| recordid | cdi_doaj_primary_oai_doaj_org_article_3c0b4c5085294b9ca44ebf58244e6eba |
| source | Publicly Available Content Database; PubMed Central |
| subjects | Age Apgar score Birth weight Births Breast feeding Breastfeeding & lactation Cesarean Section Cohort analysis Cohort Studies Debre Markos referral hospital Ethiopia - epidemiology Family physicians Female Hospitals Humans Infant Infant Mortality Infant, Newborn Intensive care Intensive Care Units, Neonatal Low income groups Male Medical referrals Mortality Mothers Neonatal care Neonatal intensive care Neonatal intensive care unit Neonatal mortality Newborn babies Newborn infants Northwest Ethiopia Obstetrics Patient outcomes Pregnancy Prenatal care Prospective Studies Public health Public health movements Questionnaires Referral and Consultation Regression analysis Respiratory distress syndrome Retrospective Studies Risk Factors Survival analysis Time Variables |
| title | Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T19%3A48%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neonatal%20mortality%20in%20the%20neonatal%20intensive%20care%20unit%20of%20Debre%20Markos%20referral%20hospital,%20Northwest%20Ethiopia:%20a%20prospective%20cohort%20study&rft.jtitle=BMC%20pediatrics&rft.au=Alebel,%20Animut&rft.date=2020-02-15&rft.volume=20&rft.issue=1&rft.spage=72&rft.epage=11&rft.pages=72-11&rft.artnum=72&rft.issn=1471-2431&rft.eissn=1471-2431&rft_id=info:doi/10.1186/s12887-020-1963-z&rft_dat=%3Cgale_doaj_%3EA616405751%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c591t-a05b2f1c4e6ea1f1ad66aa1a5b34ba8aa9e6134a313ab914a4fed97d2d90021f3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2357507083&rft_id=info:pmid/32061260&rft_galeid=A616405751&rfr_iscdi=true |