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Background <p>Preterm neonatal mortality remains a major public health challenge worldwide. Despite the availability of modifiable risk factors and cost effective interventions, data on incidence of mortality of preterm neonates in the study area is lacking. Generating local data is essential to inform tailored interventions, strengthen neonatal care services, and support national efforts to reduce neonatal mortality.</p> Objective <p>To assess incidence and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit of Wallaga University Comprehensive Specialized Hospital, Nekemte Town, Oromia, Ethiopia, from July 1, 2022, to June 30, 2024.</p> Methods <p>An institution-based retrospective cohort study was conducted among 264 preterm neonates admitted to the NICU from July 1, 2022 to June 30, 2024 and study subjects were selected using systematic random sampling technique. Data were collected using a structured checklist, key variables including ANC follow up, place of delivery, gestational age, and birth weight were extracted from medical records. Data entered via EpiData version 4.6, and subsequently analyzed using STATA version 14.0. The Cox proportional hazards model assumption was checked. A bivariable Cox regression analysis was fitted and those variable with <i>p</i> &lt; 0.2 were included in the multivariable analysis. Finally, statistical significance was declared at a <i>p</i>-value &lt; 0.05.</p> Results <p>Of the 259 preterm neonates included in the study, 42 died during the follow-up period, with an incidence proportion of 16.2%. The median survival time was 28 days (IQR: 22–30), with a total follow-up of 2,737 neonate-days. The overall incidence rate of mortality was 15.3 per 1,000 neonate-days (95% CI: 11.3–20.7). In the multivariable Cox proportional hazards regression analysis, lack of ANC follow-up (AHR: 2.27; 95% CI: 1.13–4.57), home delivery (AHR: 7.74; 95% CI: 1.99–30.03), and neonatal hypothermia (AHR: 4.11; 95% CI: 1.55–10.85) were significantly associated with increased risk of mortality, while antenatal steroid use reduced the risk of death by 56% (AHR: 0.44; 95% CI: 0.21–0.92).</p> Conclusion and recommendation <p>Lack of ANC follow-up, home delivery, and neonatal hypothermia were significant predictors of preterm neonatal mortality, while antenatal steroid use reduced the risk of death. Strengthening antenatal care utilization, promoting institutional delivery, improving thermal care, and ensuring appropriate antenatal corticosteroid administration may help improve survival among preterm neonates.</p>

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Incidence and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit of Wallaga University Comprehensive Specialized Hospital, Nekemte Town, East Wallaga, Oromia, Ethiopia: a retrospective cohort study

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  • 发表日期：

    2026年6月3日

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  • Minase Abera,
  • Fikadu Enkosa,
  • Emiru Merdassa

摘要

Background

Preterm neonatal mortality remains a major public health challenge worldwide. Despite the availability of modifiable risk factors and cost effective interventions, data on incidence of mortality of preterm neonates in the study area is lacking. Generating local data is essential to inform tailored interventions, strengthen neonatal care services, and support national efforts to reduce neonatal mortality.

Objective

To assess incidence and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit of Wallaga University Comprehensive Specialized Hospital, Nekemte Town, Oromia, Ethiopia, from July 1, 2022, to June 30, 2024.

Methods

An institution-based retrospective cohort study was conducted among 264 preterm neonates admitted to the NICU from July 1, 2022 to June 30, 2024 and study subjects were selected using systematic random sampling technique. Data were collected using a structured checklist, key variables including ANC follow up, place of delivery, gestational age, and birth weight were extracted from medical records. Data entered via EpiData version 4.6, and subsequently analyzed using STATA version 14.0. The Cox proportional hazards model assumption was checked. A bivariable Cox regression analysis was fitted and those variable with p < 0.2 were included in the multivariable analysis. Finally, statistical significance was declared at a p-value < 0.05.

Results

Of the 259 preterm neonates included in the study, 42 died during the follow-up period, with an incidence proportion of 16.2%. The median survival time was 28 days (IQR: 22–30), with a total follow-up of 2,737 neonate-days. The overall incidence rate of mortality was 15.3 per 1,000 neonate-days (95% CI: 11.3–20.7). In the multivariable Cox proportional hazards regression analysis, lack of ANC follow-up (AHR: 2.27; 95% CI: 1.13–4.57), home delivery (AHR: 7.74; 95% CI: 1.99–30.03), and neonatal hypothermia (AHR: 4.11; 95% CI: 1.55–10.85) were significantly associated with increased risk of mortality, while antenatal steroid use reduced the risk of death by 56% (AHR: 0.44; 95% CI: 0.21–0.92).

Conclusion and recommendation

Lack of ANC follow-up, home delivery, and neonatal hypothermia were significant predictors of preterm neonatal mortality, while antenatal steroid use reduced the risk of death. Strengthening antenatal care utilization, promoting institutional delivery, improving thermal care, and ensuring appropriate antenatal corticosteroid administration may help improve survival among preterm neonates.