Determinants Of Neonatal Mortality Among A Neonats Admitted To A Neonatal Intensive Care Unit At Public Hospitals In North Shoa Zone Oromia, Ethiopia; 2024: A Case Control Study

Abstract

Background: The neonatal period, the first month of life, is critical for a child's survival. Newborn mortality remains an urgent concern and an important indicator of child health, development, and well-being. Neonatal mortality in Ethiopia is unacceptably high 33 per 1000 live births according to Ethiopian demographic and health survey of 2019. Very little was investigated about Anti Natal Care Service utilization status of the mother and modes of delivery. Hence, identifying determinants of neonatal mortality and implementing evidence-based interventions at all levels is crucial to reducing neonatal mortality. Objective: This study aimed to identify determinants of neonatal mortality among neonates admitted to the neonatal intensive care unit of public Hospitals of North Shoa Zone 2024. Method: A facility-based unmatched case-control study was conducted on neonates admitted to the neonatal intensive care unit (NICU) of selected public Hospitals in North Shoa Zone from December 01, 2022 to January 30, 2023. A total of 367 charts (92 cases and 275 controls) were selected by simple random sampling technique. Data was extracted from the integrated admission and discharge log book of the NICU and charts of neonates and maternal. Epi-Data version 4.6 and SPSS version 25 software were used for data entry and analysis, respectively. Descriptive statistics were used to describe the background variable. A Bi-variable and multivariable logistic regression analysis was fitted to identify the determinants of neonatal mortality. Adjusted odds ratios with 95 % confidence intervals were used to show the determinants associated with the dependent variable at p-values < 0.05. Results: A total of 334 (86 cases and 248 controls) were included in this study. Neonatal with congenital malformation (AOR = 3.5; 95% CI: (1.4 - 9.0), APGAR scores less or equal to seven (AOR = 2.7; 95% CI :(1.3 - 5.8), absence of iron supplementation for the mother (AOR = 6.6; 95% CI: (2.5-18.0), delivery by instrumental and C/S (AOR = 4.4; 95% CI: (2.0 - 9.7) and low birth weight (AOR = 4.1; 95% CI: (2.1 - 8.0), presence of asphyxia at delivery (AOR = 2.8; 95% CI: (1.3 - 6.1) were found statistically significantly associated with neonatal mortality. Conclusions: Congenital malformation, APGAR score <7, absence of Iron supplementation for mother, mode of delivery, asphyxia and low birth weight at delivery were the major determinants of neonatal mortality.