新生児生物学ジャーナル

概要

Determinants of Neonatal Near Miss among Neonates Delivered in Public Hospitals in Shashemane City Administration, Ethiopia, 2021: Facility-Based Unmatched Case-Control Study

Henok Girma, Bikila Lenca, Lalisa Gedefa, Sintayehu Gabisa, Bonso Ami

Background: Neonatal near miss is an event that nearly died between 0-28 days but survived by chance or good quality of care. The number of neonates who survived morbidities was approximately 5 times greater than those who died. However, there is limited evidence stating the determinants of neonatal near miss in Ethiopia, particularly in Shashemane. So, this study attempted to identify determinants of Neonatal near-misses among neonates delivered in public Hospitals in Shashemene, Oromia, Ethiopia.

Methods: Facility-based unmatched case-control study conducted from March 22, 2021, to May 22, 2021. Structured and pretested questionnaires were used for data collection. 104 cases were selected consecutively and 208 controls were selected by systematic random sampling by 2^nd k during the study period. For each near-miss case, two controls were selected. After data collection, data were checked for consistency, coded, and entered by using EPI INFO 7, and exported to a statistical package for social science for analysis by using binary logistic regression based on Odds ratio, 95% CI, and p-value of less than 0.05. Variables with p<0.25 in Bivariable analysis entered into a multivariable logistic regression model using the backward variable selection method.

Result: The result shows that the mother age group between 20 and 34 had 0.12 fewer odds to experience neonatal near-misses than the age group below 20. [AOR=0.12, 95% (CI=0.02-0.76)]. Neonates who were delivered by spontaneous vaginal delivery had 0.38 fewer odds of experiencing neonatal near-misses than neonates delivered by instrumental assisted delivery and Cesarean section [AOR 0.38, 95% (CI=0.22-0.68)]. Delivery followed by partograph had 0.25 fewer odds likely to develop neonatal near miss than those not followed by partograph [AOR=0.25 95% (CI, 0.11-0.54)].

Conclusion: Age of mother, gestational age, delivery mode, and delivery followed by partograph were determinants of the neonatal near miss. So, for women who conceive at below 20 years of old, mothers that will not give birth by spontaneous vaginal delivery should be advised of the greater risk of neonatal near misses. Health workers in the delivery ward should use partograph for every delivery in both hospitals.