A Case-Control Study Examining Determinants of Neonatal Near-Miss in Public Hospitals in Tigray Region, Northern Ethiopia

Abstract

Background: A neonatal near-miss (NNM) is defined as a morbid event that nearly results in newborn death within 28 days postpartum. Every year, four million newborn babies die in the first month of life in low and middle-income countries. However, the determinants of NNM have not been studied in depth in Ethiopia. This study attempted to examine the determinants of NNM in Tigray Region, Northern Ethiopia. Method: We used unmatched case-control study in hospitals of Tigray Region, Northern Ethiopia, from February 15 to March 30, 2017. We recruited 330 respondents, including 110 cases and 220 controls using systematic random sampling to select controls, but cases were selected sequentially until the required sample size was filled. Neonates having a life-threatening complication were taken as cases and those who have no life-threatening complication were considered as controls. We used binary and multiple variable logistic regressions (odds ratio) analyses at 95% confidence. Result: Mothers of more than half of the cases and controls were found between 20–29 years of age and roughly three-fourths were married. The leading causes of NNM were neonatal sepsis (24%), hypothermia (17%), preterm/low birth weight (12%) and respiratory distress (11%). Multivariate analysis showed that being under 18 years of age at first marriage [AOR=2.8, 95%CI:1.18–6.83], history of multiple births [AOR=4.2, 95%CI:1.34–13.44], breastfeeding initiation within one hour after birth [AOR=0.02, 95%CI:0.01–0.05], mothers who had <21 cm of mid-upper-arm-circumference [AOR=14.4, 95%CI:5.83–35.75] and mothers referred from health facility [AOR=4.8, 95%CI:2.12–10.69] were positively associated with NNM. Conclusions: Age at first marriage, multiple births, breastfeeding initiation, mid-upper arm circumference and referral linkages were predictors of NNM. Parent–teenage communication in reproductive health issues starting from early adolescence to prevent teenage pregnancy through early marriage delay and life skill awareness could be of paramount importance to alleviate NNM.

Keywords: Neonatal near miss (NNM), determinants, public hospitals, Tigray, Ethiopia

Cite this Article

Nugussie F, Alemayehu M, G. Mariam K. A Case-Control Study Examining Determinants of Neonatal Near-Miss in Public Hospitals in Tigray Region, Northern Ethiopia. Research & Reviews: Journal of Medical Science and Technology. 2018; 7(3): 1–11p.