Abstract
Background: Neonatal respiratory distress syndrome is a respiratory problem recognized as one or more signs of tachypnea, Bradypnea, nasal flaring, chest retractions, grunting, and respiratory pauses. It is one of the leading causes of neonatal mortality, especially in developing countries. Although it is one of the leading causes, there haven't been studies conducted on mortality rates and predictors in Ethiopia.
Objective: To assess the mortality rate and its predictors among neonates with respiratory distress syndrome admitted to the neonatal intensive care unit of Debre Markos comprehensive specialized hospital, Northwest Ethiopia.
Method: An institution-based retrospective cohort study was conducted among 384 neonates admitted with respiratory distress syndrome to the neonatal intensive care unit of Debre Markos comprehensive specialized hospital from January 1, 2020, to March 30, 2023. Data was extracted using checklist and entered into EPI Data 4.6. Finally, export to STATA version 14.1 for further management and analysis. The Kaplan-Meier curve with the log-rank test was computed to estimate failure time and compare failure status between independent groups. Both bivariable and multivariable Cox regression models were applied to identify predictors of mortality. The model assumption was checked by a graph and the Schoenfeld residual global test. The final model's fitness was checked using the Cox-Snell residual test.
Result: Among 384 neonates with RDS 36.7% were dead during t study period, with an overall mortality rate of 7.5 per 100 neonate days of observation. The median time to mortality was 13 neonatal days (3 and 16 days of IQR), with a total follow-up of 1864 neonate-day observations. Preterm (AHR=1.54, 95% CI: 1.03–2.31), home delivery (AHR=2.25, 95% CI: 1.28–3.95), and maternal hypertension (AHR=3.59, 95% CI: 1.66-7.77) were the significant predictors.
Conclusion: This study found that the neonatal mortality rate is high. The predictors significantly associated with neonatal mortality among neonates admitted with RDS were preterm birth, home delivery, and neonates born from hypertensive mothers. Collaboration efforts are needed with families, labor and NICU health care providers, institutions, and the community to reduce neonatal mortality.