Abstract:
Background: Preterm neonatal mortality remains a global public concern, From the 130
million babies born each year globally; approximately 15 million are born and died preterm.
Ethiopia’s preterm neonatal mortality rate is unacceptably high against the goal.
Objective: To assess time to death and its predictors among preterm neonates admitted at
neonatal intensive care unit (NICU) in Debre tabor Comprehensive Specialized Hospital.
Methods: A hospital-based retrospective follow-up study was conducted among preterm
neonates admitted to the NICU in Debre tabor Comprehensive Specialized Hospital Northwest
Ethiopia from July 1 2020 to July1 2023.Data were collected after selecting participants using
computer generated simple random sampling. Data coded and entered using Epi-data version 7
and exported to STATA version 14 for analysis. Kaplan Meier curve used to compare survival
status between different categories of study participants and log rank tests used to assess its
significance level. The assumption of the cox proportional hazard model checked both
graphically using log-log stphplot and statistically using Schoenfeld residuals. Moreover,
cox-Snell residual used to test the goodness of fit. Those variables having p-value < 0.25 in the
bivariable analysis was included in the multivariable cox-proportional hazards regression model.
Finally, the level of significance for predictors declared at a p-value less than 0.05 with adjusted
hazard ratio and 95% confidence interval (CI).
Results: A total of 385 neonates followed for an overall 3781person days observation with a
median time to death of 22 days and with an incidence density of neonatal mortality, 34.6 (95%
CI: 29.3–41.4) per 1000 neonatal days. Respiratory distress syndrome (AHR: 4.0(95%CI (2.6,
5.9)), neonatal sepsis (AHR: 1.7(95%CI (1.1, 2.4)), fetal presentation at delivery (AHR:
2.1(95%CI (1.4, 3.1)) were declared predictors of preterm neonatal death. In addition, the first
week of life found a time at which most (60.3%) preterm neonate died
Conclusion: The first weeks of preterm neonate found to be the time at which most preterm
neonatal death occurred. Respiratory distress syndrome, neonatal sepsis and fetal presentation
found predictors of preterm neonatal time to death.
Recommendation: Early identification and continuous care for neonates coming with an
assessment of preterm, respiratory distress, and sepsis and due attention for the first weeks of life
should be given
