Abstract

Research Article

Determinants of neonatal near miss among neonates admitted to Ambo University Referral Hospital and Ambo General Hospital, Ethiopia, 2019

Ephrem Yohannes*, Nega Assefa and Yadeta Dessie

Published: 24 June, 2020 | Volume 3 - Issue 1 | Pages: 046-053

Background: Neonatal Near-miss is defined as complications of neonates so severe as to be imminently life-threatening but survived due to chance or treatment. The number of neonates who survived morbidities were approximately 3 to 6 times greater than those who died. There was little evidence about neonatal near miss in Ethiopia. This study attempted to identify the determinants of neonatal near miss among neonates admitted to the Ambo University Referral Hospital and Ambo General Hospital.

Methods: Hospital-based quantitative unmatched case-control study was conducted at the Ambo University Referral Hospital and Ambo General Hospital from March 1 to 28, 2019. The respondents, 134 cases and 268 controls were recruited by simple random technique. Data were coded, entered and cleaned in EpiInfo version 7 and exported to SPSS. Both Bivariable and multivariable logistic regression was computed at 95% CI and the final model was checked by Hosmer and Lemeshow goodness -of-fit test. Multi collinearity and cofounders were not detected.

Result: Multivariate analysis showed that distance more than 15km away from health facilities [AOR=2.11, 95% CI: (1.09, 4.095)], Unwanted, and unplanned current pregnancy [AOR=3.71, 95% CI: (1.28, 10.79)], less than four Antenatal care visit [AOR=6.55, 95% CI: (3.07, 13.98)], Instrumental delivery [AOR=4.62, 95% CI: (1.78, 11.98)] were positively associated with Neonatal Near Miss. Whereas Term Neonates [AOR= 87%, 95% CI: (0.05, 0.32)], and Normal birth weight [AOR=91%, 95% CI: (0.03, 0.28)] were negatively associated with Neonatal Near Miss.

Conclusion: Distance from health facilities, Antenatal care visit, current pregnancy type, birth weight, gestational age and mode of delivery were determinants of Neonatal Near Miss. Therefore, providing adequate Antenatal services, health education and training is needed to improve neonatal health.

Read Full Article HTML DOI: 10.29328/journal.cjog.1001050 Cite this Article Read Full Article PDF

Keywords:

Neonatal near miss; Determinants; Ambo; Ethiopia

References

  1. Say L. Neonatal near miss: a potentially useful approach to assess quality of newborn care. J Pediatr. 2010; 86: 1-2. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20151097
  2. Surve S, Chauhan S, Kulkarni R. Neonatal near miss review: Tracking its conceptual evolution and way forward. Curr Pediatr Res. 2017; 21: 264-271.
  3. Santos JP, Cecatti JG, Serruya SJ, Almeida PV, Duran P, et al. Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system. Clinics (Sao Paulo). 2015; 70: 820-6. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676313/
  4. Femhealth, near miss and quality of care tool. n.d.
  5. Pileggi-Castro C, Camelo JS, Jr, Perdoná GC, Mussi-Pinhata MM, Cecatti JG, et al. Development of criteria for identifying neonatal near-miss cases: analysis of two WHO multicountry cross-sectional studies on Maternal and Newborn Health Research Network. WHO, 2014. PubMed: https://pubmed.ncbi.nlm.nih.gov/24641541
  6. UNICEF, et al. Levels & Trends in Child Mortality: Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation (IGME), in New York, USA. 2012.
  7. Every newborn: An action plan to end preventable deaths. 2014. www.who.int/about/licensing/copyright_form/en/index.html
  8. Maternal mortality. 2015. http://www.who.int/mediacentre/
  9. Lawn JE, Cousens S, Zupan JL, Neonatal Survival Steering:4 million neonatal deaths: when? Where? Why? Lancet. 2005; 365: 891-900. PubMed: https://pubmed.ncbi.nlm.nih.gov/15752534/
  10. Avenant T, Neonatal near miss: a measure of the quality of obstetric care. Best Pract Res Clin Obstet Gynaecol. 2009; 23: 369-374. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19201262
  11. Silva AAM, Leite AJM, Lamy ZC, Moreira MEL, Gurgel RQ, et al. Neonatal near miss in the Birth in Brazil survey. Cad Saúde Pública. 2014; 30. PubMed: https://pubmed.ncbi.nlm.nih.gov/25167178
  12. Victora CG, B. FC. Infant mortality due to perinatal causes in Brazil: trends, regional patterns and possible interventions. . Sao Paulo Med J. 2001; 119: 33-42.
  13. Lansky S, et al. Pesquisa Nascer no Brasil: perfil da mortalidade neonatal e avaliação da assistência à gestante e ao recémnascido. Cad Saúde Pública. 2014; 30: 192-207.
  14. Gonçalves AC, Camelo JS, Jr, Perdoná GC, Mussi-Pinhata MM, Cecatti JG, et al. Tendência da mortalidade neonatal na cidade de Salvador (Bahia-Brasil), 1996-2012. Rev Bras Saúde Mater Infant. 2015; 15: 337-347.
  15. Pileggi‐Castro C. et al. Development of criteria for identifying neonatal near‐miss cases: analysis of two WHO multicountry cross‐sectional studies. BJOG: Int J Obstet Gynaecol. 2014; 121: 110-118. PubMed: https://pubmed.ncbi.nlm.nih.gov/24641541
  16. !!! INVALID CITATION !!! .
  17. Tekleab AM, Metaferia AG, Ya T. Reasons for admission and neonatal outcome in the neonatal care unit of a tertiary care hospital in Addis Ababa: a prospective study. Res Reports Neonatol. 2018; 6: 16.
  18. Kale L, de Mello-Jorge MHP, da Silva KS, Fonseca SC. Neonatal near miss and mortality: factors associated with life-threatening conditions in newborns at six public maternity hospitals in Southeast Brazil. Cad Saude Publica. 2017; 33: e00179115. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28538795
  19. Silva GA. A populational based study on the prevalence of neonatal near miss in a city located in the South of Brazil: prevalence and associated factors. Rev Bras Saúde Matern Infant Recife. 2017; 17: 159-167.
  20. Emmanuel EN. Factors associated with early neonatal morbidity and mortality in an urban district hospital in douala, cameroon. Int J Latest Res Sci Technol. 2016; 5: 43-49.
  21. EDHS, Central Statistical Agency (CSA) [Ethiopia] and ICF Key Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA CSA and ICF. 2016.
  22. Briggs P. The Bradt Travel Guide. 3 ed. 1. 2002, Ethiopia Chalfont St Peters: Bradt. 483.
  23. Santos J, Pileggi-Castro C, Camelo JS, Jr, Silva AA, Duran P, et al. Neonatal near miss: a systematic review. BMC Pregnancy Childbirth. 2015; 15: 320. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26625905/
  24. De Lima THB, Katz L, Kassar SB, Amorim Neonatal near miss determinants at a maternity hospital for high-risk pregnancy in Northeastern Brazil: a prospective study. BMC Pregnancy Childbirth. 2018; 18: 401. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30314456
  25. American College of Obstetricians and Gynecologists, Guidelines for Perinatal Care. American Academy of Pediatrics. 2012; 7.
  26. Apgar V. A proposal of a New Method of Evaluation of the Newborn Infant. Current Researches in Anesthesia and Analgesia. 1953; 32: 267. PubMed: https://pubmed.ncbi.nlm.nih.gov/13083014
  27. Apgar V, Holaday DA, James LS. Evaluation of the newborn infant. JAMA. 1958; 168: 1985-1988. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/13598635
  28. Battaglia FC, Lubchenco LO. A practical classification of newborn infants by weight and gestational age. J Pediatr. 1967; 71: 159-163. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6029463
  29. Alexander GR, Himes JH, Kaufman RB. A United States national reference for fetal growth. Obstet Gynecol. 1996; 87: 163-168. PubMed: https://pubmed.ncbi.nlm.nih.gov/8559516
  30. Faix RG, Viscardi RM, DiPietro MA, Nicks JJ. Adult respiratory distress syndrome in full-term newborns. Pediatrics. 1989; 83: 971-976. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2657626
  31. Hayelom GM, Sahle BW. Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study. BMC Public Health. 2017; 17: 62. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28077109
  32. Weldearegawi B. Cohort of 3684 births. Infant mortality and causes of infant deaths in rural Ethiopia: a populationbased. BMC Public Health. 2015; 15: 770.
  33. Upadhyay RP, Dwivedi PR, Rai SK, Misra P, Kalaivani M, et al. Determinants of Neonatal Mortality in Rural Haryana: A Retrospective Population Based Study. indian paediatrics. 2012; 49. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21992859
  34. Mats Målqvist, et al. Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern Vietnam. BMC. 2010; 10: 176. PubMed:
  35. Gayral TM. et al. Caractéristiques socio-démographiques et risques périnatals des mères en situation de précarité. Journal de Gynécologie Obstétrique et. Biologie de la Reproduction. 2005; 34: 23-32.
  36. Kassar SB, Melo AM, Coutinho SB, Lima MC, Lira PI, et al. Determinants of neonatal death with emphasis on health care during pregnancy, childbirth and reproductive history. J Pediatr. 2013; 89: 269-277. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23680300
  37. Brasil, Secretaria de Atenção à Saúde. Departamento de Ações Programáticas E Área Técnica de Saúde da Mulher. Pré-natal e Puerpério: atenção qualificada e humanizada - manual técnico. Ministério da Saúde Brasília, D F. 2005.
  38. Nascimento RM. Determinantes da mortalidade neonatal: estudo caso-controle em Fortaleza, Ceará, Brasil. Cad Saúde Pública. 2012; 28: 559-72.
  39. Doukkali L. Factors of Neonatal Morbidity at the Provincial Hospital Center of Missour. Journal of Biosciences and Medicines. 2016; 4: 48-57.
  40. Klima CS. Unintended pregnancy. Consequences and solutions for a worldwide problem. J Nurse Midwifery. 1998; 43: 491. PubMed: https://pubmed.ncbi.nlm.nih.gov/9871381/
  41. da Silva AAM, Leite AJM, Lamy ZC, Moreira MEL, Gurgel RQ, et al. Neonatal near miss in the Birth in Brazil survey. Saúde Pública, Rio de Janeiro. 2014; 30: 1-10. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25167178
  42. Pileggi C, Souza JP, Cecatti JG, Faúndes A. Neonatal near miss approach in the 2005 WHO Global Survey Brazil. Jornal de Pediatria. 2010; 86: 21-26.
  43. Santos JP, Cecatti JG, Serruya SJ, Almeida PV, Duran P, et al. Paho Neonatal Near Miss working Grou Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system. Clinics. 2015; 70: 820-826. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676313/
  44. Mengesha HG, Wuneh AD, Lerebo WT, Tekle TH. Survival of neonates and predictors of their mortality in Tigray region, Northern Ethiopia: prospective cohort study. BMC Pregnancy Childbirth. 2016; 16: 202. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27485138
  45. Muwanguzi P, Byaruhanga R, Nyangabyaki C. Risk Factors Of Neonatal Near Miss At A Peri-Urban Hospital In Uganda. n.d. PubMed:
  46. Kassahun CW, Mekonen AG. Knowledge, attitude, practices and their associated factors towards diabetes mellitus among non diabetes community members of Bale Zone administrative towns, South East Ethiopia. A cross-sectional study. PLoS ONE. 2017; 12: e0170040. https://www.ncbi.nlm.nih.gov/pubmed/28152066
  47. Asmamaw A, Asres G, Negese N, Fekadu A, Assefa G. Knowledge and Attitude About Diabetes Mellitus and Its Associated Factors Among People in DebreTabor Town, Northwest Ethiopia: Cross Sectional Study. Sci J Public Heal. 2015; 3: 209.
  48. Ayano M, Beyene AW, Geremew A. Prevalence and Outcome of Caesarean Section in Attat Hospital, Gurage Zone, SNNPR, Ethiopia. iMedPub J. 2015; 7: 8.
  49. Feven N, Mussie A, Mariam KG. A Case-Control Study Examining Determinants of Neonatal Near-Miss in Public Hospitals in Tigray Region, Northern Ethiopia. J Med Sci Technol. 2018; 7: 11.

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