Time to Death and Predictors Among Neonates with Neural Tube Defects in Two Public Hospitals, Addis Ababa, Ethiopia:...

Neural tube defects are a collection of intricate congenital abnormalities that affect the central nervous system. Neural tube defects cause 88,000 deaths globally and 29% in developing countries. Neural tube defects take a significant portion of the congenital anomalies in Ethiopia. This study aimed to assess the time to death, as hazard and predictors among neonates with neural tube defects in two public hospitals, Addis Ababa, Ethiopia.

A retrospective cohort study was conducted by reviewing medical charts of 410 randomly selected neonates with neural tube defects, registered from 2018 to 2022 in Addis Ababa, Ethiopia. Data collection and entry was done from February 20 to March 20/2023 using KoboCollect v2022.4.4. STATA/14 was used for data screening, and SPSS/27 was used for analysis. The Kaplan-Meier survival analysis and Cox proportional hazards model were used for inferential analysis. Findings with p ≤ 0.05 were observed as statistically significant.

A total of 410 neonates were followed for 4100 person-days of risk time and 35 (8.54%) of neonates expired. The overall incidence rate of mortality was 8.54 per 1000 neonate days of observation with a median survival time of 25 days (95% CI: 22.7-27.3). Being preterm, Adjusted Hazard Ratio (AHR) = 2.62, (95% CI 1.12, 6.14), having low birth weight (AHR: 2.62, 95% CI 1.13, 6.10), encephalocele (AHR: 3.77, 95% CI 1.65, 8.62), cervical and occipital lesion level (AHR: 3.97, 95% CI, 1.17, 13.49), presence of hydrocephalus (AHR: 3.98, 95% CI 1.55, 10.21), and Chiari-II malformation (AHR: 2.40, 95% CI 1.03, 5.57) were demonstrated to be statistically significant predictors of time to death.

The cumulative incidence of death of neonates diagnosed with neural tube defects was observed. Early diagnosis and timely management of patients is decisive in lowering the mortality.