Time to Death and Predictors of Mortality in Neonates Admitted to Tibebe Ghion Referral Hospital, Neonatal Intensive Care Unit in Northwest Ethiopia: A Retrospective Follow-Up Study.

BACKGROUND AND AIMS: The first 28 days of life, the neonatal period, represent a phase of heightened vulnerability for infant survival globally. Despite advancements in medical interventions and increased healthcare access, a substantial number of newborns continue to succumb to preventable causes annually. This study aimed to ascertain the time to death and its associated factors among neonates admitted to the Neonatal Intensive Care Unit (NICU) at Tibebe Ghion Specialized Hospital, Ethiopia.

METHODS

A retrospective follow-up design was employed, encompassing 385 neonates admitted to the NICU of Tibebe Ghion Specialized Hospital between September 11, 2022 and September 5, 2023. Data were extracted from patient records using a standardized checklist. The outcome was time to death, with surviving neonates considered censored. Data were analyzed using STATA version 17. Kaplan-Meier survival curves analyses were used to estimate the probability of death over time. A Cox proportional hazards model was utilized to identify independent predictors of neonatal mortality. Variables with a p value < 0.05 in the multivariable Cox regression were deemed statistically significant at a 95% confidence interval.

RESULTS

Among the 385 neonates, 12.73% experienced mortality, yielding an incidence rate of 43.80 deaths per 1000 neonatal days (95% CI: 0.03-0.06). The median time to death for neonates was 7 days (95% CI: 6.00, 8.00). After multivariable adjustment, respiratory distress syndrome (Adjusted Hazard Ratio [AHR]: 3.00; 95% CI: 1.27-7.75), congenital anomalies (AHR: 2.90; 95% CI: 1.42-5.91), very low birth weight (AHR: 2.50; 95% CI: 1.18-5.28), and gestational diabetes mellitus (AHR: 4.00; 95% CI: 1.76-9.67) were identified as significant independent predictors of neonatal death.

CONCLUSION

The incidence of neonatal mortality observed in this setting was notable. Respiratory distress syndrome, congenital anomalies, very low birth weight, and gestational diabetes mellitus were found to be independently associated with an increased risk of neonatal death.