Incidence of mortality and Its Predictors among Jaundiced Neonates Admitted in Neonatal Intensive Care Unit of University of Gondar Comprehensive Specialized Hospital, 2023

Abstract

Background: Neonatal death is still the global challenge; its burden is highest in sub-Saharan Africa, and so it is an issue in Ethiopia. Neonatal jaundice is one of the cause of hospitalization during the first week of life worldwide and it may cause severe bilirubin-induced impairment and death. Therefore, determining the neonate's incidence of mortality from jaundice and identifying risk factors is essential to prevent the death that comes with it. Objective: The aim of this study was to determine incidence of mortality and its predictors among neonates with jaundice admitted to the neonatal intensive care unit of University of Gondar Specialized Hospital from January 2020 to May 2023. Methods: A facility-based retrospective follow-up study was employed among 566 randomly selected neonates admitted in University of Gondar Comprehensive Specialized Hospital from January 2020 to May 2023. Data were extracted from medical chart by a checklist and entered into Epi-Data version 3.1 and analyzed with STATA version 17. To calculate the survival time and contrast survival curves between variables, a Kaplan Meier estimate and a log-rank test were computed. To find predictors, correlated with incidence of jaundice mortality, the Cox proportional hazard model was also fitted. Statistical level of significance was declared at p-value ≤0.05 and reported with 95% confidence interval. Result: A total of 566 neonates were included in this study, 75(13.25%) of which were died, and the incidence rate was 14.56 per 1000 person-day-observations. Hypothermia AHR 2.07 (95% CI: 1.09, 3.77), Rh incompatibility AHR 3.20 (95% CI: 1.91, 5.61), high level of total bilirubin AHR 9.70 (95% CI: 5.97, 15.84) and comorbidity AHR 2.41 (95% CI: 1.28, 5.26), were predictors of mortality among neonates with jaundice. Conclusion: In this study, the overall incidence rate during the 5,149 person-time was 14.56 per 1,000 person-day observations. Most predictors that determine jaundiced neonatal death were hypothermia, Rh incompatibility, hyper bilirubinemia, and comorbidity. Therefore, early detection and treatment of the aforementioned predictors would be crucial to prevent neonatal death.