Abstract:
Background: Neonatal Near Miss is a neonate who nearly died but survived from a
severe complication occurred during pregnancy, birth or within 0-28 days of life.
Identifying Neonatal near miss cases and correcting contributing factors are of the
utmost importance to get relevant controls for neonatal death. However, few studies
have been conducted to assess the prevalence of neonatal near misses and the factors
associated with neonatal near miss cases in Ethiopia, where neonatal mortality is
high.
Objectives: To assess the magnitude of neonatal near miss and associated factors
among neonates delivered in hospitals of Southwest Shoa Zone, Central Ethiopia,
2022. Methods: An institution-based cross-sectional study was conducted from
September, 9 to November 8, 2022, in five selected hospitals in the Southwest Shoa
Zone. The data were collected by interviewer-administered structured questionnaire
with maternal and neonatal records review for systematically selected 356 mothers
and their respective neonates. Data were coded, entered into Epi Info, and then
exported to SPSS version 20 for analysis. To identify factors associated with neonatal
near misses, bivariable and multivariable logistic regression analyses were used.
Finally, an adjusted odds ratio with a 95% confidence interval was used to identify the
strength and direction of the association, and statistical significance was declared at P
< 0.05.
Result: The magnitude of the neonatal near miss was 104 (29.2%) at 95% CI: 24.47-
33.96%). An inadequate antenatal care visit [AOR: 2.66; 95%CI: 1.49–4.76],
antepartum hemorrhage [AOR: 5.28; 95%CI: 1.72–16.18], premature rupture of
membrane [AOR: 4.03; 95%CI: 1.88–8.64], pregnancy-induced hypertension [AOR:
3.07; 95%CI: 1.15–8.14], non-vertex presentation [AOR: 5.27; 95%CI:1.83-15.16]
and delivery by cesarean section [AOR:2.96;95%CI:1.28-3.87] were identified as
significant determinants of neonatal near miss.
Conclusion and recommendation: Nearly three in ten neonates delivered in
hospitals develop neonatal near miss. Inadequate antenatal care, obstetric
complications, cesarean delivery, and non-vertex presentation were all independent
risk factors for a neonatal near miss. Therefore the study implies to strengthening
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adequate antenatal care visits and early detection and appropriate management of
obstetric complications have importance to reduce neonatal near miss.
