Abstract:
Introduction: Respiratory distress is the most common reason for neonates to be
resuscitated and admitted to a neonatal intensive care unit. It is a major cause of early
neonatal mortality and a challenge to recovery in the neonatal intensive care unit,
especially in middle- and low-income countries. Apart from this, time to recovery and its
predictors among neonates with respiratory distress are not well studied.
Objective: The aim of this study was to determine the time to recovery and its
predictors in neonates admitted with respiratory distress to the neonatal intensive care
unit of Northwest Amhara Regional Comprehensive Specialized Hospital in
northwestern Ethiopia in 2023.
Methods: A prospective follow-up study of 603 neonates was conducted using
systematic random sampling technique. Data were entered into Epi-data version 4.6.0.2
and exported to STATA version 17 for analysis. The Kaplan-Meier test and log-rank test
were used to estimate and compare the survival time. A Cox proportional hazards
model was fitted. The appropriate model for the data was selected according to AIC,
and Weibull regression was chosen. The goodness of fit test was checked using Cox Snell residuals. Finally, the adjusted hazard ratio was calculated with 95% CI, and
variables with a P- value < 0.05 were considered significant predictors of recovery time
for respiratory distress.
Result: A total of 603 neonates were enrolled in this study, of which 446 (73.96%)
recovered with a median survival function mean time of 7.54 days with a 95% CI 7.33 -
7.74). The median survival time was 9 days with an IQR (5-13 days). Predictors
affecting recovery time were prolonged labor (AHR=0.68; 95% CI: 0.48–0.95), sepsis
(AHR=0.73; 95% CI: 0.57–0.95), low birth weight (AHR=0.48; 95% CI: 0.36-0.65), very
low birth weight (AHR=0.08-0.27), and CPAP (AHR=1.44; 95% CI: 1.07-1.95).
Conclusion and recommendation: The median overall time to recovery from
respiratory distress was slightly higher in this study compared with other studies.
Sepsis, low birth weight, very low birth weight, CPAP and mother who had prolonged
labor history were found to be statistically significant variables. To shorten recovery
time, special attention should be paid to neonates born from prolonged labor history,
having sepsis, low birth weight, and very low birth weight. In addition, recovery time can
also be shortened by promoting CPAP use.
