Survival and predictors of early neonatal death in neonatal intensive care unit of Mekelle general and Ayder comprehensive specialized hospitals, Northern Ethiopia, 2018: prospective cohort study

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Abstract Background: Early neonatal mortality refers to deaths of neonates between 0 and 6 days of life. This contributes three-quarters of neonatal deaths globally. Its predictors vary by country with the availability and quality of health care, which was chosen as the measure of mortality and remains a global public health concern especially in sub-Saharan African countries, including Ethiopia. So the aim of this study is to determine incidence, median survival time and to identify the predictors of early neonatal mortality.Methods: A prospective cohort study was conducted in Mekelle general and Ayder comprehensive specialized hospitals, Tigray, Ethiopia from January to March, 2018. Data were collected from 253 newborns admitted to the neonatal intensive care unit by interviewing mothers using structured questionnaires and followed for seven completed days of life (day 0 to 6).Kaplan Meier curves were used to estimate survival time, Log-rank test was used to look statistical differences among/between the categories of variables and Cox regression model was used to identify potential predictors of early neonatal deaths. The analysis was conducted using a computer program Stata version 12.Results: Overall, in this study 32 (12.65%) neonates died which makes the early neonatal mortality rate 126.5 per 1000 live births. The median survival time of early neonates was 2 days. Predictors of early neonatal mortality were very low birth weight (AHR= 3.02; 95 % CI: 1.11, 8.25) and preterm birth (AHR=3.7; 95 % CI: 1.22, 11.188). Conclusion: This study shows high incidences of early neonatal mortality. Very low birth weight and preterm birth were major predictors for early neonatal mortality. Managing complications of preterm and very low birth weight, preventing preterm delivery and improving quality of services and ensuring a continuum of care are recommended to increase survival of early neonate

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