INCIDENCE AND PREDICTORS OF MORTALITY AMONG NEONATES ADMIT TED TO THE NEONATAL INTENSIVE-CARE UNIT (NICU) OF SAWLA GEN ERAL HOSPITAL, SOUTHERN ETHIOPIA: RETROSPECTIVE COHORT STUDY

Abstract

Background; Neonatal mortality refers to the death of neonates within the first 28 days of life. In 2017, 2.5 million newborns died globally, with 80% of these deaths occurring in Sub-Saharan Africa and Southern Asia. Most neonatal deaths happened within the first week of life, with 36% occurring on the first day. The researcher had limited prior knowledge about the study area Objective: The main aim of this study is to assess incidence and predictors of mortality and as sociated factors among neonates admitted to in NICU (neonatal intensive care unit) it in Sawla General Hospital, Goffa Zone, South Ethiopia, 2024. G C Method: A facility-based retrospective follow-up study was conducted among cohort of 410 neonates admitted in NICU of SGH from June 1 to July 30, 2024, covering the period from Jan uary 1, 2021, to August 31, 2023. Systematic random sampling was used to select neonates who were admitted to the NICU during this period. Data were collected using Kobo Collect and ana lyzed using Stata 17. Cox proportional hazards regression analysis was applied to assess the ef fects of covariates on neonatal mortality. Adjusted hazard ratios (AHR) with corresponding 95% confidence intervals (CI) were reported, and all statistical tests were considered significant at a p-value of < 0.05 Result: The overall incidence of neonatal mortality was 22.4 (95% CI: 17.4, 28.9) per 1000 neo natal days. Initiation of exclusive breastfeeding (EBF) after 1 hour (AHR = 3.60, 95% CI: 1.27 10.23), neonatal age > 1 days (AHR=3.44, 95% CI, 1.53 - 7.76), low birth weight (AHR=4.30, 95% CI: 1.99–9.24), male neonates (AHR = 3.08; CI: 1.37–6.93). Maternal Pregnancy induced hypertension [AHR: 2.6; 95% CI: 1.1, 6.22] and 5th-minute Apgar score ≤5 (AHR = 2.69, 95% CI: 1.38–5.24) were increased the risk of neonatal mortality. Conclusion and Recommendation: The incidence rate of neonatal death was notably high in the study area. The findings revealed that factors such as male sex, a low 5-minute APGAR score, maternal pregnancy-induced hypertension (PIH), low birth weight, age beyond one day, and delayed initiation of breastfeeding were significant predictors of neonatal mortality. There fore, it is crucial to promote programs that provide comprehensive training on early exclusive breastfeeding (EBF) for mothers and to implement community-based strategies aimed at improv ing neonatal survival, particularly for mothers in the Goffa Zone