Magnitude of preterm hospital neonatal mortality and associated factors in northern Ethiopia: a cross-sectional study

OBJECTIVE: This study aimed to assess the magnitude of preterm neonatal mortality in hospitals and associated factors in northern Ethiopia. DESIGN: Institutional-based cross-sectional study. SETTING: Comprehensive specialised hospitals in the Tigray region, northern Ethiopia. PARTICIPANTS: Preterm neonates admitted in Ayder and Aksum comprehensive specialised hospitals PRIMARY OUTCOME: Magnitude of preterm neonatal mortality. SECONDARY OUTCOME: Factors associated with preterm neonatal mortality RESULT: This study was conducted from 1 April 2019 to 15 May 2019 among 336 participants with a response rate of 96.8%. The magnitude of preterm neonatal mortality was 28.6% (95% CI: 24.0 to 33.7). In multivariable logistic regression, respiratory distress syndrome (adjusted odd ratio (AOR)=2.85; 95% CI: 1.35 to 6.00), apnoea of prematurity (AOR=5.45; 95% CI: 1.32 to 22.5), nulli parity (AOR=3.63; 95% CI: 1.59 to 8.24) and grand parity (AOR=3.21; 95% CI: 1.04 to 9.94) were significant factors associated with preterm neonatal mortality. However, receiving Kangaroo mother care (AOR=0.08; 95% CI: 0.03 to 0.20) and feeding initiated during hospitalisation (AOR=0.07; 95% CI: 0.03 to 0.15) were protective against preterm neonatal mortality. CONCLUSIONS: The magnitude of preterm neonatal mortality in hospitals was still high. Interventions geared towards curbing preterm in-hospital neonatal mortality should strengthen early diagnosis and treatment of preterm newborns with respiratory distress syndrome and apnoea of prematurity; while concomitantly reinforcing the implementation of kangaroo care and early feeding initiation is important.