Related Experiment Video
Updated: Jun 21, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Determinants of neonatal mortality among preterm births in Black Lion Specialized Hospital, Addis Ababa, Ethiopia: a
Yared Asmare Aynalem1, Hussien Mekonen2, Kenean Getaneh3
1Debre Berhan University, Debre Berhan, Amhara, Ethiopia yaredasmare123@gmail.com.
Insights
Preterm neonatal mortality remains high in Ethiopia. Key determinants include maternal diabetes, neonatal sepsis, respiratory distress, extreme prematurity, low Apgar scores, and premature rupture of membranes.
Area of Science:
- Neonatal Health
- Public Health
- Epidemiology
Background:
- Preterm neonatal death is a significant global health challenge, particularly in Ethiopia where it's a leading cause of newborn and under-5 mortality.
- Despite government interventions to improve preterm infant survival, mortality rates have not decreased as expected.
Purpose of the Study:
- To identify the key determinants contributing to preterm neonatal mortality in Ethiopia.
Main Methods:
- An institution-based retrospective case-cohort study analyzed data from preterm neonates born between March 2013 and February 2018.
- 170 deceased preterm neonates (cases) and 404 surviving preterm neonates (controls) were included.
- Multivariate logistic regression was employed to identify significant predictors of mortality.
Main Results:
- The overall incidence of preterm neonatal mortality was 39.1 per 1000 neonate-days.
- Significant predictors included maternal diabetes mellitus (AOR: 2.3), neonatal sepsis (AOR: 1.6), respiratory distress (AOR: 1.5), extreme prematurity (AOR: 2.9), low Apgar score (AOR: 3.1), and premature rupture of membranes (AOR: 2.3).
Conclusions:
- High rates of preterm neonatal mortality are associated with specific maternal and neonatal factors.
- Targeted interventions focusing on maternal diabetes, sepsis, respiratory distress, prematurity, Apgar scores, and membrane rupture are crucial for reducing preterm neonatal deaths.
Background:
Preterm neonatal death is a global burden in both developed and developing countries. In Ethiopia, it is the first and fourth cause of newborn and under-5 deaths, respectively. From 2015 to present, the government of Ethiopia showed its effort to improve the survival of neonates, mainly preterm births, through the inclusion of high-impact life-saving neonatal interventions. Despite these efforts, the cause of preterm neonatal death is still not reduced as expected. Therefore, this study aimed to identify determinants of preterm neonatal mortality.
Methods:
An institution-based retrospective case-cohort study was conducted among a cohort of preterm neonates who were born between March 2013 and February 2018. A total of 170 cases were considered when the neonates died during the retrospective follow-up period, which was confirmed by reviewing a medical death certificate. Controls were 404 randomly selected charts of neonates who survived the neonatal period. Data were collected from patient charts using a data extraction tool, entered using EpiData V.3.1 and analysed using STATA V.14. Finally, a multivariate logistic regression analysis was performed, and goodness of fit of the final model was tested using the likelihood ratio test. Statistical significance was declared at a p value of ≤0.05.
Results:
In this study, the overall incidence rate of mortality was 39.1 (95% CI: 33.6 to 45.4) per 1000 neonate-days. Maternal diabetes mellitus (adjusted OR (AOR): 2.3 (95% CI: 1.4 to 3.6)), neonatal sepsis (AOR: 1.6 (95% CI: 1.1 to 2.4)), respiratory distress (AOR: 1.5 (95% CI: 1.1 to 2.3)), extreme prematurity (AOR: 2.9 (95% CI: 1.61 to 5.11)), low Apgar score (AOR: 3.1 (95% CI: 1.79 to 5.05)) and premature rupture of membranes (AOR: 2.3 (95% CI: 1.8 to 3.5)) were found to be predictors.
Conclusion:
In this study, the overall incidence was found to be high. Premature rupture of membranes, maternal diabetes mellitus, sepsis, respiratory distress, extreme prematurity and low Apgar score were found to be predictors of neonatal mortality. Therefore, it should be better to give special attention to patients with significantly associated factors.
