SURVIVAL AND PREDICTORS OF MORTALITY AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT AT BOMBE PRIMARY HOSPITAL, SOUTHERN ETHIOPIA, INISTITUTIONAL BASED RETROSPECTIVE COHORT STUDY.

Abstract

Background: Neonatal mortality includes all deaths of neonate occurring before 28th day of life. Neonatal mortality has been declining over two decades in Sub-Saharan Africa, including Ethiopia. The foremost causes of death are preventable and treatable. In spite of this, identifying the predictors could be an important step to reducing neonatal mortality. However, evidences on the survival status of neonates and/or neonatal death predictors were limited in Ethiopia, particularly in the study area. Objective: To assess survival and predictors of mortality among neonates admitted to Neonatal Intensive care Unit at Bombe Primary Hospital, 2020. Methods: Institutional based retrospective cohort study was conducted among 380 Neonates who were admitted to Neonatal Intensive Care Unit at Bombe Primary Hospital from January 1, 2018- December 31, 2019. Both bivariate and multivariate Cox regression analyses were conducted to identify predictors of mortality. Association was summarized using AHR, and statistical significances were declared at 95% CI and P-value < 0.05. Proportionality assumption was tested by global test based on Schoenfeld residuals analysis. Results: - The overall incidence of neonatal mortality was 20.8 (95% CI: 15.2, 28.5) per 1000 neonatal days. The independent predictors of time to death were initiation of EBF after 1 hr. [AHR:2.9; 95% CI: 1.32, 6.37], 5th min APGAR score <5[AHR:3; 95% CI:1.32;6.88], low birth weight [AHR:2.59; 95% CI:1.1,6.26], hypothermia[AHR:2.6; 95% CI:1.1,6.22] and mothers time of rupture of membrane >12 hours before delivery [AHR:2.49; 95% CI: 1.25,4.97] which were increased the risk of neonatal mortality, while caesarian section delivery 91.6% [AHR= .084; 95% CI: 0.10, 0.65] and ANC utilization 61% [AHR:0.39; 95% CI: 0.15– 0.91] were decreased the risk of neonatal mortality. Conclusion: The incidence of Neonatal mortality rate was high in NICU at Bombe primary hospital. Low birth weight, lower 5th minute Apgar score, hypothermia, failure to early initiation of breast feeding and mothers time of rupture of membrane >12 hours before delivery were independent predictors of neonatal mortality. Therefore, managing complications and low birth weight, initiating exclusive breast feeding, improving quality of services and ensuring a continuum of care are recommended to increase survival of neonates.