Time to death and its predictors among neonates admitted to neonatal intensive care unit with perinatal asphyxia in Public Hospitals in East Wallaga Zone, Western Ethiopia, 2023: A retrospective cohort study

Abstract

Abstract Background Perinatal asphyxia cause babies progressively marked impairment of gas exchange and multi-organ system dysfunction due to limited oxygen flow. It is major cause of newborn deaths in the Sub-Saharan Africa region and it contributes 280,000 deaths a year with 31 per 1000 live births case fatality rate. Even though different initiatives and prevention strategies have implemented, neonatal mortality due to perinatal asphyxia is high in Ethiopia. This study aimed to assess time to death and its predictors among neonates admitted to neonatal intensive care units by perinatal asphyxia in public hospitals of East Wallaga Zone, Ethiopia, 2023. Method Hospital based retrospective cohort study design was conducted from July 01 2019 to June 30 2022. Systematic sampling technique was employed. Data was coded and entered into EpiData version 4.6 and exported to STATA version 14. Kaplan Meier survival curve and log rank test was used to estimate the survival probability. Log-log plot and global tests was used to assess proportional hazard assumption. Cox Snell residual was used to assess overall model adequacy. Cox proportional hazards regression model was used to determine predictors of mortality. Hazard Ratios (HR) with 95% confidence intervals was computed and statistical significance was declared when it is significant at 5% at p value < 0.05. Result From a total of 519 neonates, 27.36% of them were died. The overall incidence of mortality was 45.54 per 1000 (95%CI: 38.63, 53.68) person days observation with median time to death of 4 days. Living in rural area (AHR = 2.69, 95%CI: 1.67, 4.39), delivered from primiparity mothers (AHR: 1.78, 95%CI: 1.01, 2.92), preterm birth (AHR: 1.76, 95%CI: 1.08, 2.87) and having previous history of abortion (AHR: 1.95 95% CI: 1.23, 3.01) were found to have association with the incidence of mortality. Conclusion and recommendation : There was high neonatal mortality rate due to perinatal asphyxia. This mortality was high among neonates those whose mothers live in rural area, primiparity mothers, has previous history of abortion and preterm birth babies. Therefore, health workers should give special emphasis for neonates admitted by perinatal asphyxia.