Factors associated with mortality and length of stay in hospitalised neonates in Eritrea, Africa: a cross-sectional study

OBJECTIVE: To determine the factors associated with mortality in a hospitalised cohort of infants in Asmara, Eritrea. DESIGN: Retrospective cross-sectional review of all 2006 admissions to a specialised neonatal intensive care unit. Data on gestational age (prematurity), age at presentation, birth weight, gender, mode of delivery, Apgar score, maternal age, birth location, admission diagnosis, admission comorbidities, time of admission and outcome were collected. SETTING: Orotta Pediatric Hospital ‘Specialised Neonatal Intensive Care Unit’ (SNCU) in Orotta National Maternity Referral Hospital, the nation's only tertiary newborn centre. PRIMARY AND SECONDARY OUTCOME MEASURES: Factors associated with mortality and length of stay via multivariate regression analysis and the combined association of both hypothermia and pneumonia. Other outcome measures were determination of the association of admission hypothermia, time of admission and pneumonia on mortality. RESULTS: A total of 1502 infants were admitted to the SNCU with an average preterm gestational age of 35.9 weeks. 87 died (mortality 8.2%). In bivariate analysis, the highest mortality rate (10.3%) was seen in patient's admitted <1 h after birth. Patients with hypothermia or pneumonia exhibited higher mortality rates (13.6% and 13.4%, respectively). In multivariate analysis, birth weight <2 kg (p<0.01), birth weight between 2.1 and 2.5 kg (p<0.01), Apgar score at 1 min (p<0.01), small for gestational age (p<0.01), hypothermia (p<0.04) and pneumonia (p<0.01) were associated with mortality. CONCLUSION: Hypothermia, pneumonia, younger gestational age, 1 min Apgar score and small size for gestational age are significantly associated with mortality and longer length of stay in the Eritrean SNCU.