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Article Type

Article

Subject Area

Obstetrics and Gynecology

Abstract

Aim Neonatal mortality accounts for most infant mortality. Various factors influence the risk of neonatal mortality. Available estimates of survival and mortality in neonatal intensive care units (NICUs) are needed to provide antenatal counseling and guide management decisions. This study aimed to determine the predictors of admitted neonatal mortality. Patients and methods A retrospective study was done between June 2016 and May 2018 in the NICU of El-Galaa Teaching Hospital to determine the predictors of admitted neonatal mortality. Data were collected as follows: premature rupture of membranes, mode of delivery, multiple or single pregnancy, sex, weight, gestational age (GA), Apgar score at 5 min, mechanical ventilation use, presence of hemorrhage during the course of treatment, central nervous system (CNS) problems, pneumothorax, and neonatal sepsis. Univariate analysis and logistic regression analysis were done to determine the predictors of mortality. Results A total of 987 neonates were enrolled in this study. Nonsurvivors represented 41.9%, whereas survivors represented 58.1%. Results show a statistically significant difference of more deaths with multiple pregnancy, vaginal delivery, mechanical ventilation, sepsis, pneumothorax, CNS problems, hemorrhage, low GA, low birth weight, low Apgar score at 5 min, and low days of NICU admission. Findings from bivariate analysis showed that hemorrhage, mechanical ventilation, pneumothorax, CNS problems, vaginal delivery, and sepsis were significantly associated with less time to death. Cox regression analysis and odd ratio showed that hemorrhage, sepsis, and pneumothorax have the most effect on mortality, whereas high GA and high Apgar score at 5 min are significant to survival. Conclusions The study revealed that most NICU deaths occurred in the first week and showed that hemorrhage, sepsis, and pneumothorax have the most effect on mortality, whereas higher GA and higher Apgar score at 5 min to survival.

Keywords

Neonatal mortality, neonatal intensive care unit, prediction

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