RESEARCH THESIS SUBMITTED TO SCHOOL OF PUBLIC HEALTH, COLLEGE OF MEDICINE AND HEALTH SCIENCE, ARBAMINCH UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE MASTER OF PUBLIC HEALTH DEGREE.

Abstract

Background: Preterm related complications are the single largest direct cause of neonatal death worldwide and are responsible for 35% of neonatal deaths worldwide. In Ethiopia preterm related complications are still the leading cause of neonatal mortality. Identifying the hazard time to death and predictors of mortality plays an important role to in decreasing preterm mortality. Objective: To assess incidence of preterm death and its predictors among preterm neonates admitted to Arba Minch General Hospital, Arba Minch town, Southern Ethiopia 2024G.C Methods: A retrospective cohort study was conducted on 362 randomly selected neonates. All preterm neonates admitted to the NICU between Jan 1, 2017, and December 30, 2022, composed the source population. Data were extracted from medical charts, entered into KOBO data collector tool and analyzed by SPSS window version 25.0. Descriptive statistics;- and bivariable and multivariable analyses were performed with a Cox regression model. Variables with a P value <0.05 were considered to have a statistically significant ability to predict preterm mortality. Result: A cohort of 362 preterm neonates contributed 2,890.025 neonate-days at risk, with neonatal mortality rate of 32.9 deaths (95% CI: 26.9, 40.2) per 1,000 neonate-days. Being male [AHR= 1.72 (95% CI: 1.10, 2.66)], birth weight (<1500 grams) [AHR= 2.06 (95% CI: 1.31, 3.24)], hypothermia at admission [AHR=2.80 (95% CI: 1.68, 4.65)], perinatal asphyxia [AHR= 1.79 (95% CI: 1.07, 2.99)], respiratory distress syndrome [AHR= 1.82 (95% CI: 1.19, 2.78)] and receiving kangaroo mother care [AHR= 0.20 (95% CI: 0.12, 0.32)] were predictors of preterm neonatal mortality. Conclusion: The preterm neonatal mortality rate was found to be a significant problem in the present study. The majority of preterm neonatal death occur in the early neonatal period. Therefore, early detection and management of preterm birth-related complications, encouraging kangaroo-mother care, and ensuring a continuum of care should be strengthened.