SURVIVAL STATUS AND PREDICTORS OF MORTALITY AMONG LOW-BIRTH-WEIGHT NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN SELECTED PUBLIC HOSPITALS OF DIRE DAWA CITY ADMINSTRATION AND HARARI REGIONAL STATE , EASTERN ETHIOPIA, 2024.

Abstract

Background: Low-Birth-Weight is a serious public health concern in low- and middle-income countries. Globally, more than 20.5 million neonates were born as low-birth-weight and more than 96% of these Low-Birth-Weight newborns are born in developing countries. Although the World Health Assembly targeted to reduce Low-Birth-Weight by 30% by the end of 2025, a little success has been achieved in Ethiopia. Objective: To assess the survival status and predictors of neonatal mortality among low birth weight neonates admitted to neonatal intensive care units in public hospitals of Dire Dawa city administration and Harari regional state, eastern Ethiopia, in 2023. Methods: An institution-based retrospective follow-up study was conducted among 560 low birth-weight neonates admitted to the neonatal intensive care unit, by reviewing chart from January1, 2020-December 30, 2022.proportional allocation to sample size was made for each hospital and then simple random sampling by computer generating method was used to select neonatal charts. A checklist was used to extract pertinent information. Epi-data version 4.6 was used for data entry, and then exported to Stata14 software for analysis. To estimate the cumulative survival time and compare the probability of survival time among variables, the Kaplan-Meier survival curve, and the Log-rank test was used. Bivariable and multivariable Cox proportional hazard model was used to identify predictor variables. Model goodness-of-fit was checked by Cox Snell residuals & an assumption was checked by using Schoenfeld residual test. Results: The overall incidence density was 67.85 per 1000 person-day observations (95%CI: 59.15, 78.21) with 2932 person-days observation and median survival time of 12 days. Being born from a mother living outside the city (rural resident) [AHR= 1.5(1.05, 1.99)]. Unable to breast feeding [2.3(AHR: 2.3 (95%, CI: 1.38, 2.79)], lack of Kangaroo-Mather Care [AHR: 1.6 (95%, CI: 1.015, 2.43)], neonatal sepsis [(AHR: 1.6 (95% CI: (1.15,2.25)], Perinatal asphyxia [AHR:2.2(95% CI:1.48,1.15)], and Necrotizing Enter colitis [AHR:2.7 (95% CI:1.53, 1.70)] were found to be significant predictors of death among low-birth-weight. Conclusion and recommendation: The incidence rate of LBW neonatal mortality was high and continues as a public health issue. The median survival time of the neonate was 12 days. Therefore, an intervention that focuses on the identified predictors could have a paramount effect in reducing low birth weight neonatal death.