MORTALITY AND ASSOCIATED FACTORS AMONG PRETERM NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT OF HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Although different strategies and interventions are being implemented, mortality among preterm neonates (delivered before 37 weeks) is one of the highest in low resource settings like Ethiopia. Therefore, there is a need for context specific evidence to identify factors associated with mortality among preterm neonates to improve the provision of care. Objective: To assess the magnitude of and factors associated with mortality among preterm neonates admitted to the neonatal intensive care unit of Hiwot Fana Specialized University Hospital, Eastern Ethiopia, from June 15 to July 14, 2021. Method: Institutional-based cross-sectional study design was conducted among 622 randomly selected preterm neonates admitted in the neonatal intensive care unit of Hiwot Fana Specialized University Hospital. Data on socio-demographic conditions, obstetric factors, and fetal outcomes at discharge were extracted from medical records using a standard checklist. The data were entered into EpiData 3.1 and then exported to SPSS 22 for analysis. Crude and adjusted logistic regression analysis were fitted to identify the association between independent variables and preterm neonatal mortality. Association was expressed using adjusted odds ratio (AOR) along with 95% confidence interval (CI). Finally, p-value <0.05 was considered as cut-off point for statistically significant association. Results: Of 622 records reviewed, 610 (98%) were included in the analysis, of which 194 (31.8%) (95% CI: 28.0, 35.2) died. Factors associated with mortality were being born from women with no antenatal care (AOR=2.45; 95% CI 1.55,3.87), low birth weight (AOR= 2.71; 95% CI= 1.83,4.01), neonatal sepsis (AOR= 2.31; 95% CI= 1.54,3.44), perinatal asphyxia (AOR= 1.99; 95% CI= 1.34,2.94), jaundice (AOR= 2.20; 95% CI= 1.03,4.69) and hypoglycemia (AOR= 1.93; 95% CI= 1.25,2.98). Conclusion: Nearly a third of preterm neonates admitted in the neonatal intensive care unit of Hiwot Fana Specialized University Hospital were died. No antenatal care, low birth weight, sepsis, perinatal asphyxia, jaundice and hypoglycemia were independently associated with mortality. Improving the survival of preterm neonates requires addressing infection prevention methods and provision of immediate newborn care