Determinants of Neonatal Mortality among Neonates Admitted to Neonatal Care Unit at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract Background : Neonatal mortality is a critical indicator of a nation's health and economic well-being. Globally, 2.3 million newborns died in the first month of life in 2022, and approximately 6,300 neonatal deaths occur every day. Sub-Saharan Africa has the highest neonatal mortality rate, with 27 deaths per 1,000 live births. Ethiopia remains among the countries with the highest neonatal mortality rates and seems impossible to meet the Sustainable Development Goal (SDG) target of ≤12 deaths per 1,000 live births by 2030. Therefore, it is crucial to identify the current determinant factors of neonatal mortality for targeted intervention. The study aimed to identify the determinants of neonatal mortality among newborns admitted to the neonatal care unit of St. Paul Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methods : A retrospective unmatched case-control study was conducted on neonates admitted to the neonatal intensive care unit (NICU) of St. Paul Hospital Millennium Medical College from January 2020 to December 2022. A total of 324 (108 cases and 216 controls) were randomly selected. Data were collected using a pretested data extraction checklist. Multi-variable logistic regression was applied to identify significant determinants of neonatal mortality, with AOR at 95% C and P < 0.05 used to declare statistical significance. Results : The median age of mothers and neonates was 26.9 years and 7 days, respectively . Based on a multivariable model, pregnancy-induced hypertension (AOR: 1.5; 95% CI: 1.61-3.90), lack of ANC visit (AOR: 12; 95% CI: 4.23-15.8), low birth weight (AOR: 11.7; 95% CI: 5.6-25.6), prematurity (AOR: 4.2; 95% CI: 1.4-12.6), fetal malpresentation (AOR: 2.1; 95% CI: 1.05-2.6), and home delivery (AOR: 8.0; 95% CI: 4.2-19.4) were significant determinants of neonatal mortality. Conclusion : This study highlights lack of ANC follow-up, home delivery, pregnancy-induced hypertension, low birth weight, prematurity, and fetal malpresentation as significant determinants of neonatal mortality. Therefore, a special targeted attention should be given to ANC follow-up and subsequent institutional delivery and focused newborn care to address the complications related to preterm and low birth weight.