Magnitude and risk of neonatal death in neonatal intensive care unit at referral hospital in Godeo Zone: a prospective cohort study

Abstract

Introduction: even though newborn health is apriority agenda in Ethiopia, neonates’ risk of dying is unacceptable and one of the ten countries which accounts to two-third of global neonatal death. The magnitude and risk of death in the referral care facility was not well studied in the study area. This study was aimed to estimate neonatal death and its determinant.

Methods: a prospective cohort study was conducted from November 2016 to January 2018 among neonates admitted to Dilla University Referral Hospital Neonatal Intensive Care Unit. We generated descriptive statistics and Cox-proportional hazard model to identify independent risk factors of neonatal death.

Results: we identified 913 neonates with 6836 person-days of follow-up. Overall, 11.6% (n = 106) deaths of neonates were recorded. The estimated hazard ratios of neonatal death were higher among neonates whose mothers did not attend ANC follow up (HR=3.23), delivery assisted by TBA (HR=2.19), and maternal age ≥ 30 years at birth (HR=2.04). Urban residence [HR=0.54], family size of ≤ 3 (HR=0.47) and family size of 4 - 6 (HR=0.49), absence of abortion (HR=0.55), absence of illness during pregnancy (HR=0.47), iron folate intake (HR=0.29), birth weight ≥ 2500 grams (HR=0.43) were found to be protective factors.

Conclusion: neonatal death at referral neonatal intensive care unit was relatively high. Early management of complications, improving quality of services at neonatal intensive care unit and ensuring maternal continuum of care are recommended to increase survival of neonates. Besides, maternal and neonatal health-related factors were among the independent risk factors that need to design context-based policy and interventions.