Pattern of Admission and Outcome of Neonates Admitted to Neonatal Intensive Care Unit at Jimma Medical Center, South West Ethiopia

Abstract

Background: Neonatal period is the most susceptible period of life, the newborn has adapt to a totally new environment and is vulnerable to many problems. Children face the highest risk of dying in their first month of life for example there were 17 deaths per 1,000 live births in 2019.Globaly,most of the neonatal deaths (around 99%) occur in developing countries particularly in sub-Saharan African and south central Asian countries. For many years, the neonatal mortality rate in Ethiopia remains greater than 30 per 1,000 live births. Hence, identifying the pattern for neonatal admission and outcome in a hospital setting is crucial to improve the quality of existing practices. Methods: Institution based prospective longitudinal study was conducted in a neonatology unit, at Jimma medical center from February 1, 2021 to August 1, 2021. Structured questionnaire used to capture the relevant data and Epi Data version 4 and SPSS version 25 used for data entry and analysis respectively. Descriptive statistics carried out to see the pattern of admission and outcome whereas bivariate and multivariate logistic regression analysis performed to determine factors associated with mortality at P value of less than 0.05 at a CI of 95% considered as significant. Results: Out of the total 380 neonates enrolled, 222 (58.4%) were male, 61.6% of mothers came from the surrounding district. The main causes of admissions were neonatal sepsis (55.5%), prematurity with respiratory problem (28.9%), hyperbilirubinemia (18.9%), and asphyxia (13.9%). Regarding the outcome, 75.8% of admitted neonates were discharged alive and the hospital neonatal mortality rate was 24.2%. The average length of hospital stay was 8.7 days (SD 7.5 days). Neonates who were diagnosed to have Respiratory distress syndrome have increased risk of death [AOR=1.92, (95% C.I :)] (1.06-3.38).birth weight, maternal education and Respiratory distress syndrome have significant association with mortality (p- value <0.05). Conclusion and recommendation Most of the neonates were diagnosed with neonatal infection, prematurity, and hyperbilirubinemia. The hospital neonatal death rate seen in this study is high; which indicates the need for improving the quality of neonatal care. Therefore adequate resource should be put in place to improve neonatal outcomes