Predictors of Preterm Neonatal Mortality in Hawassa University Comprehensive Specialized Hospital Neonatal Intensive Care Unit, Southern Ethiopia: a Retrospective Cohort Study

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Abstract BACKGROUND: The issue of preterm neonates has paramount significance for achieving aims to end all preventable deaths of newborns and children below 5 years by 2030. Globally more than 1 million preterm neonates died out of 15 million babies born preterm every year and the problem is more significant in developing countries like Ethiopia. OBJECTIVE: The aim of this study was to assess survival status and predictors of mortality among preterm neonates admitted to the Neonatal Intensive Care Unit of Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia, 2021 METHODS: An Institutional based retrospective cohort study was conducted in Hawassa University Comprehensive Specialized Hospital from May 9–30, 2021 after getting ethical clearance from the Institutional Review Board of Hawassa University College of Medicine and Health Sciences. The study population was all preterm neonates admitted to neonatal intensive care units (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH) from May 9, 2019, to April 22, 2021. After reviewing different literature and neonatal national guideline, the data abstraction tool was developed and utilized after making some modifications. After collection, data were entered into epi data software version 3.1 and exported to STATA for data cleaning and further analysis. The level of significance was set at p<0.05 with the corresponding confidence intervals at 95% confidence. The Cox proportional hazard ratio was used to assess the association between dependent and independent variables. RESULTS: The magnitude of preterm neonatal mortality was 33.3%. The final model revealed that early initiation of breast milk (AHR: 0.43 (95% CI: 0.29, 0.62), Early neonatal sepsis at admission (AHR: 1.34(95% CI: 1.003, 1.79), 5th minute Apgar score of less than 7 (AHR: 1.73(95% CI: 1.17, 2.55), perinatal Asphyxia (AHR: 2.25(95% CI: 1.67, 3.02) and recent multiple pregnancies (AHR: 1.66(1.22, 2.26) were significantly associated predictors of preterm neonatal mortality. CONCLUSION: Preterm neonatal mortality remains a significant health problem in Hawassa University Comprehensive Specialized Hospital. It is basic to revamp the current work procedures and practices through the improvement of antenatal care, early breastfeeding, and timely detection of perinatal asphyxia, early neonatal sepsis, and hypertension

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