Abstract:
Abstract
Introduction: Perinatal asphyxia is one of the preventable and treatable causes of neonatal mortality.
However it is the fifth largest cause of under-five mortality. There are both long-term and short-term
neurodevelopmental consequences of perinatal asphyxia, which can result in disability or even death.
Even though management advancements, it remains one of the key public health issues in underdeveloped
countries, including Ethiopia. Comorbidities are also understated therefore adequate information
regarding the incidence of death and its predictors is required.
Objective: To assess incidence and predictors of mortality among neonates with perinatal asphyxia
admitted in neonatal intensive care unit at west Oromia region referral hospitals, Ethiopia, 2022.
Methods: A four-year retrospective follow-up study was conducted from October 03 to November 02,
2022, among 655 neonates with perinatal asphyxia. From a total sample size, 616 data were collected by
nurses reviewing charts using Kobo Toolbox software. Data was exported to STATA Version 14 for
analysis. Cox proportional hazard assumption was checked. The appropriate model for the data was
selected by Akaike Information Criteria. Finally, an adjusted hazard ratio with 95% CI was computed, and
variables with a P-value <0.05 in the multivariable analysis were taken as significant predictors of death
among perinatal asphyxia.
Result: The overall incidence of mortality was 38.86/1000 days (95%CI: 33.85-44.60). The median time
of follow-up was 15 days (95% CI: 14-20). The proportion of deaths was 202 (32.79%, 95% CI: 29.18-
36.61) among neonates with perinatal asphyxia. While distance from health facility >10 KM is (AHR:
2.25; 95%CI: 1.60-3.17), direct oxygen (AHR= 1.83; 95% CI: 1.35-2.48), APGAR score<3 at fifth
minute (AHR= 2.63; 95% CI: 1.03-6.73), prolonged ROM (AHR=1.41; 95% CI: 1.02-1.94), and
stage III HIE (AHR= 2.02; 95% CI: 1.18-3.47) were a predictors of mortality, among neonates with
perinatal asphyxia.
Conclusion and recommendation: The study found that, neonatal mortality among perinatal
asphyxia remains high. The important predictors of death were prolonged ROM, APGAR score <3 at
fifth minute, using direct oxygen, stage III HIE, and a place of residences more than 10KM away from the
health facility. Therefore, in order to reduce neonatal mortality among asphyxiated neonates with these
predictions require an advanced care.
Keywords: Perinatal Asphyxia, Incidence, Predictors, Mortality, Ethiopia.
