Predictors of mortality among newborns admitted with perinatal asphyxia at public hospitals in Ethiopia: A Prospective cohort study

Abstract Introduction: Perinatal asphyxia is a fetus or the newborn's health problem caused; due to altered breathing or inadequate inhalation and exhalation resulting in reduced oxygen perfusion to certain body tissues and organs. Irrespective of the increased progress in health care towards newborns and implementations in reductions in under-five, infant, and neonatal mortality in the past ten years, perinatal asphyxia remains as the most common severe newborn health challenge causing a high number of mortalities and morbidity and is a major public issue. Methods A prospective cohort longitudinal study was implemented among the predetermined 573 samples of newborns admitted with Perinatal asphyxia at public hospitals in Southern Ethiopia from 1st March 2018 to 28th February 2020. Data entry was conducted using Epi data version 3.02 statistical software and exported to SPSS Version 25 statistical software for analysis. The perinatal survival time was determined using Kaplan Meier survival curve together with a log-rank test. Variables that had a P-values less than 0.05 in the multivariable cox proportional hazard model were declared as statistically significant predictors of mortality. Results The cumulative proportion of survival among the newborns admitted with perinatal asphyxia was 95.21% (95%CI:91.00,97.48), 92.82% (95%CI:87.95,95.77), 92.02%(95%CI:86.84,95.22) and 90.78%(95%CI:84.82,94.48) at the end of first, second, third and fourth follow-up days respectively with the overall mean survival time of 6.55(95%CI:6.33,6.77). Cord prolapse (AHR:6.5;95%CI:1.18,36.01), history of PIH (AHR:25.4;95%CI:3.68,175.0), maternal iron deficiency anemia (AHR:5.9;95%CI:1.19,29.5) and having convulsion of the newborn (AHR:10.23;95%CI:2.24,46.54) were statistically significant in multivariable cox proportional hazard model. Conclusion The risk of death among newborns with perinatal asphyxia was high during the early follow-up periods after admission to the hospital and the mortality risk decreased at the later follow up periods and cord prolapse, history of PIH, maternal history of iron deficiency anemia and newborns history of convulsion were the independent predictors of mortality.