Incidence and predictors of mortality among neonates admitted with perinatal asphyxia at west Oromia region referral hospitals, Ethiopia, 2022.

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.