Determinants of mortality among preterm neonates admitted at Wolaita Sodo University Comprehensive Specialized Hospital, southern Ethiopia: An unmatched case-control study.

Background: Preterm birth accounts about 1 million neonatal deaths worldwide and the second causes of both neonatal and under five-child mortality. From this preterm is the second leading cause of death and is steadily increased in low-income countries. In Ethiopia, Preterm neonatal death is the first and fourth cause of newborn and under-5 deaths, respectively. Although the general newborn mortality rate in the research area was 27 per 1000 neonates, but the preterm neonatal mortality rate and determinants were not previously well recognized. This study aimed to identify the Determinants of preterm neonatal mortality admitted to WSUCSH, with some variations from other studies carried out in in terms of the environment, hospital setting and the inclusion of additional factors.

Methods: An institution-based, unmatched case-control study was conducted from June 1-15, 2023 on preterm neonates who admitted to Wolaita Sodo University Comprehensive Specialized Hospital from July 1, 2020, to June 30, 2022. A total of 690 with 1:2 ratio (230 cases and 460 controls respectively) preterm neonate medical charts were used for data extraction using a pre-established tool. Data were checked for completeness and consistency, entered using Epi-Data V.4.6, and transported to SPSS version 26 for analysis. Multivariate logistic regression analysis was performed to identify the independent determinants of preterm neonate mortality at a p value of < 0.05 along with a 95% confidence interval (CI). Finally, the model fitness of the study was assessed using the Hosmer and Lemshow model fitness test.

Results: The preterm neonatal death rate was 10.9%. Hypothermia (AOR = 1.66, 95% CI:1.03-2.67), Sepsis (AOR = 3.35, 95% CI: 1.25 8.96), hypoglycemia (AOR = 2.85, 95% CI:1.09-7.44), Respiratory distress syndrome(RDS) (AOR = 7.21 95% CI:2.18-23.92), necrotizing enter colitis (AOR = 7.92, 95% CI:2.96-21.12) and neonates who stayed at hospital less than 7 days (AOR = 7.36, 95% CI:2.82,19.22) were predictors of preterm mortality.

Conclusion And Recommendation: Preterm neonatal mortality in this setting is mainly related to sepsis, respiratory distress syndrome (RDS), necrotizing enter colitis (NEC), hypoglycemia, hypothermia, and brief hospital stay. Thus, it would be preferable to offer appropriate prevention measures and extra care for neonates who have those factors.