Survival status and predictors of mortality among low birth weight neonates admitted to the neonatal intensive care unit at jimma medical center, southwest Ethiopia: a retrospective cohort study

Abstract

Background: Low birth weight contributes to more than 80% of neonatal deaths. The neonatal mortality rate in Ethiopia has not been as per planned by national and global goals and targets. There is a paucity of evidence on low-birth-weight neonatal mortality and predictors in the study area. Objective: To assess survival status and predictors of mortality among low birth weight neonates admitted to the neonatal intensive care unit at Jimma Medical Center from 01/01/2017-12/30/2021, Jimma, Ethiopia. Methods: An institution-based retrospective cohort study was conducted from May 1 to Jun 30, 2022, among 300 low birth weight neonates admitted to the NICU at Jimma Medical Center from 2017 to 2021. Data were collected from randomly selected medical records. Data were entered into EpiData 4.6, and exported to STATA 14.0 for analysis. Kaplan Meir and log-rank test were used to estimate survival time, and compare survival experience. Cox-regression analysis was fitted to identify independent predictors of time to death. Assumption of proportional hazard model was checked using Schoenfeld residual test (Global test). The 95% CI of hazard ratio with p-value <0.05 was set to declare statistical significance. Results: A cohort of 300 low birth weight neonates was followed for 2437.63 neonate-days. There were 85(28.3%) death during the follow-up period. The overall neonatal morality rate was 34.9 deaths per 1,000 neonate-days [95% CI: 28.2, 43.1]. Incidence of neonatal mortality in first week of life was 46.6 deaths per 1,000 neonate-days (95% CI: 36.3, 59.9). Obstetric complication on current pregnancy [AHR=3.62, 95%CI: 1.5, 8.76], birth weight [AHR=0.9, 95%CI: 0.998, 0.999], respiratory distress syndrome [AHR=4.16, 95%CI: 1.44, 12.03], Anemia [AHR=2.69, 95%CI: 1.08, 6.75], and not receiving photo therapy [AHR=2.43, 95%CI: 1.07, 5.54] were significant predictors of mortality. Conclusion: The mortality rate was higher from target. Predictors of low birth weight neonatal mortality were obstetric complications during the current pregnancy, birth weight, respiratory distress syndrome, anemia, and not receiving photo therapy. Hence, continued life support and comprehensive care is needed for neonates with respiratory distress syndrome and anemia