Mortality of preterm neonates and its predictors in the Northwest part of Ethiopia: A retrospective cohort study

Abstract Abstract Background: Preterm birth is highly reported in some countries and disparities on survival rates of preterm neonate are escalating across countries. Providing adequate medical care during pregnancy and childbirth has been endorsed. However, neonatal mortality is continuing to be one of the sustainable development goals. To achieve this aim, data from the different geographical area is suggested. Objective: This study was aimed to assess mortality of preterm neonates and its predictors in the Northwest part of Ethiopia. Methods: Institution based retrospective cohort study was conducted among 535 preterm neonates. Data was entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for analysis. Kaplan-Meier survival analysis and Log-rank test were used to see statistical differences between categories of variables. Cox proportional hazard model was used to identify independent predictors of preterm neonatal mortality. The proportional assumption test had been checked using the Schoenfeld residual test. Variables with p-value ≤ 0.05 were considered as predictors of preterm neonatal mortality. Results: In this study, 31.2% (95% CI: 27.3, 35.1) of preterm neonate were died. Preterm neonates with a gestational age of less than 32 weeks (AHR=1.74; 95%CI: 1.24, 2.46), being male sex (AHR=1.38; 95%CI: 1.01, 1.90), born from preeclampsia/ eclampsia mothers (AHR=1.95; 95%CI: 1.13, 3.36), being extremely very low birth weight (AHR=2.94; 95%CI: 1.05, 8.24), diagnosed with respiratory distress syndrome (AHR=1.70; 95%CI: 1.20, 2.41) were predictors of preterm death. Conclusion and Recommendations: Preterm neonatal mortality found to be high. Four neonatal and one maternal-related variable were recognized predictors of mortality in preterm neonates. The study suggests preventing and controlling preeclampsia/ eclampsia, especial care for neonates born with very low birth weight, born before 32 weeks of gestation, and diagnosed with respiratory distress syndrome are imperative. Keywords: Preterm, Neonate, Mortality, Ethiopia