TIME TO RECOVERY FROM ASPHYXIA AND ITS PREDICTORS AMONG NEWBORNS ADMITTED TO NEONATAL INTENSIVE CARE UNITS AT PUBLIC

Abstract

Introduction: Birth asphyxia is one of the causes of early neonatal mortality globally. Similarly, the burden of birth asphyxia in Ethiopia remains high. Thus, researches on time to recovery of asphyxiated neonates and its’ predictors are critical to tackle it. Therefore, the current study intended to determine time to recovery of asphyxiated neonates and its’ predictors among newborns admitted in neonatal intensive care unit of public hospitals of North Shewa, Amhara region, Ethiopia Methods: An institution-based retrospective cohort study was conducted among 523 asphyxiated neonates admitted to the Neonatal Intensive Care Units of selected public hospitals in North Shoa from January 1, 2020, to December 31, 2023. A simple random sampling method was applied to choose the study participants. The data was collected by using the Kobo data-collecting tool and then exported to STATA version 14.0 statistical software for further analysis. The neonatal survival time was estimated by using the Kaplan-Meier survival curve, and the survival time between different categorical variables was compared using the log-rank test. Bivariate and multivariable Cox proportional hazards regression analyses were performed to verify predictors of survival of birth asphyxia. RESULT: A total of 523 admitted asphyxiated newborns were monitored for 3682 neonate-days of observation which ranged from a minimum of 1 day to a maximum of 28 days. The overall proportion of survival was 79.1%. Seven days (95% CI: 6.60-7.39) was the median recovery time. Depressed Moro reflex (AHR: 0.52, 95% CI: 0.38-0.87), being stage I hypoxemic ischemic encephalopathy (AHR: 2.5, 95% CI: 1.65-5.87), neonates who had not received calcium gluconate (AHR: 1.40, 95% CI: 1.02 1.68), and neonates managed with 2/3 of intravenous fluids during their stay (AHR: 0.68, 95% CI: 0.53-0.99) were predictors for time to recovery of asphyxiated newborns. CONCLUSION: The overall proportion of recovery is lowered in comparison to other research findings, to fasten the recovery time from asphyxia, standardized care protocols including fluid and electrolyte monitoring could be established.