Determinants of Neonatal Mortality among Newborns Admitted to Neonatal Intensive Care Unit at SPHMMC and TBGH, Addis Ababa, Ethiopia: Unmatched Case Control Study

Abstract

Abstract Background: Neonatal mortality, the death of infants within the first 28 days of life, is a crucial indicator of a population's health. Despite a global decline in infant mortality, neonatal deaths remain a major concern, particularly in sub-Saharan Africa. Ethiopia experiences a high neonatal mortality burden. The leading causes include preterm birth complications, birth asphyxia, and infections. However, limited research exists on the factors influencing neonatal mortality in Ethiopia. Objective: To assess the determinants of neonatal mortality among newborns admitted to the Neonatal Intensive Care Unit (NICU) at St. Paul’s Hospital Millennium Medical College (SPHMMC) and Tirunesh Beijing general hospital (TBGH) in Ethiopia Methods: Institutional based case control study was conducted among neonates, cases (80) and controls (160), at SPHMMC and TBGH from December, 2023 up to November, 2024. Data was collected using a structured and pre-tested checklist from medical records. Study units are selected using simple random sampling methods. Data was checked for completeness and consistency, entered using Kobo toolbox, and transported to SPSS version 26 for analysis. The binary logistic regression model was used, variables with p-value < 0.25 were entered to final multivariable analysis. In multivariable analysis variables with p-value < 0.05 at 95% confidence interval was set as a statistically significant association between the independent and outcome variables. Result: Neonatal age at admission (AOR = 0.49, 95%CI = 0.25–0.95), length of stay in NICU (AOR = 14.4, 95%CI = 5.6–36.8) and number of gestations (AOR = 4.54, 95% CI = 1.82 11.34), were found to be determinants of neonatal mortality. Conclusion: The study found that the length of hospital stays, age at admission, and gestational age were the main risk factors for neonatal mortality. To reduce neonatal mortality, prioritize early admission of neonates to NICU, and optimize length of stay based on individual needs, and implement targeted interventions for multiple gestations. Keywords: Neonatal mortality, newborn, NICU, Addis Ababa, Ethiopia