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Determinants of mortality among preterm neonates admitted with respiratory distress in Addis Ababa public hospitals neonatal intensive care units, 2021, Multi-center prospective follow-up study.

Dires Birhanu Mihretie, Mequanint Ayehu Akele, Markos Wodajie Sisay, Fekadeselassie Belege Getaneh, Natnael Moges Misganawu, Yitayal Guadie, Yohannes Godie Ashebir

Background: Respiratory distress is a breathing problem that affects newborns, mostly those who are born preterm, the earlier a baby is born, the more likely the baby will develop respiratory distress. Some studies were conducted about incidence and associated factors of respiratory distress in preterm neonates but there are constraints of studies regarding on determinants of preterm mortality admitted with respiratory distress. Thus, this study will provide an important input to improve treatment practice and increase neonatal survival rate especially those neonates are highly vulnerable to death due to the most frequent preterm complications (respiratory distress). Objective: To identify determinants of mortality among preterm neonates admitted with respiratory distress in Addis Ababa public hospitals neonatal intensive care units, 2021. Methods: This institutional based prospective follow up study was conducted in Addis Ababa public hospitals neonatal intensive care units among all preterm neonates admitted with respiratory distress from February 12-May 12, 2021. Collected data was entered in to Epi data version 4.6 and it was exported to SPSS version 26 software for further analysis. After computing bi-variable logistic regression, variables with p-value ≤ 0.25 were taken into multi-variable model to minimize confounders. The cut point to declare the presence of statistical significance between the variables were p-value < 0.05 or AOR, 95% CI. Results: This study concluded that, mortality of preterm neonates admitted with respiratory distress was 43.7 % (CI: 0.38-0.50). Pre-eclampsia/eclampsia (AOR=2.9, 95% CI: 1.32-6.39), feeding initiation time > 24 hours of admission (AOR=5.4, 95% CI: 2.24-12.86), NEC (AOR=4.4, 95% CI: 1.67-11.59), thrombocytopenia (AOR= 3.7, 95% CI: 1.45-10.27) and hyperbilirubinemia (AOR=0.19, 95% CI: 0.08-0.46) were the identified determinants for preterm mortality admitted with respiratory distress. Conclusion and Recommendation: In this study, mortality among preterm neonates admitted with respiratory distress was high. Therefore, major interventions on the identified determinants have to be implemented and further studies shall be conducted on preterm neonates with neonatal hyperbilirubinemia.