The effect of birth weight on time to neonatal mortality in Silte Zone, Central Ethiopia: A survival analysis

Abstract Introduction: Globally, 2.4 million children died in the first month of life by 2019, approximately 6,700 neonatal deaths every day. Ethiopia is 4th leading country among the top 10 countries with the highest number of neonatal death. On the other hand, prospective studies regarding neonatal mortality are scarce in Ethiopia in general and the central Ethiopia part in particular which necessitates assessing survival status and predictors of mortality among neonates to design evidence-based locally specific intervention strategies. Methods An institution based prospective cohort study design was employed from May 01 to July 30, 2022. Data were collected from term neonates enrolled by their order of health facility visit then followed by data collectors in their home. Data were analyzed using STATA version 14.1. Neonatal survival was presented using Kaplan-Meyers survival curve. Crude and adjusted association was evaluated using cox-proportional hazard model and presented with 95% confidence interval and P value < 0.05 was used to declare statistical significance. Result 1080 term neonates were followed for a total of 27643.6 neonatal day. The study showed a 95% cumulative probability of surviving the neonatal period. The incidence rate of neonatal death was 2.02 per 1000 neonatal days. Maternal history of neonatal death (AHR = 4.03; 95%CI: 2.28–9.52), complication during pregnancy (AHR = 3.08; 95%CI: 1.12–8.25), female sex (AHR = 0.45; 95%CI: 0.25–0.84), birth weight (AHR = 0.27; 95%CI: 0.11–0.63), and low and intermediate Apgar score (AHR = 3.11; 95%CI: 1.23–7.82 and AHR = 5.34; 95%CI: 1.63–17.51 respectively) were independent predictors of neonatal death. Conclusion It has been noted that neonatal mortality is higher than results from national and other study areas and thus needs strict attention, and interventions targeting both pre and post-natal periods. Promoting maternal nutrition thereby normal birth weight of the newborn increases the survival status of neonates.