Time to recovery of asphyxiated neonates and its’ predictors among newborns admitted to neonatal intensive care unit at Debre Berhan Comprehensive Specialized Hospital, Ethiopia

Abstract

Abstract Background Neonatal asphyxia is a leading cause of early neonatal mortality, accounting for approximately 900,000 deaths each year. Assessing survival rates, recovery time and predictors of mortality among asphyxiated neonates can help policymakers design, implement, and evaluate programs to achieve the sustainable development goal of reducing neonatal mortality to 12/1,000 live births by 2030. The current study sought to ascertain the survival status, recovery time, and predictors of neonatal asphyxia. Methods A retrospective follow-up study conducted in Debre Berhan Comprehensive Specialized Hospital, which carried out from May 20th to June 20th, 2023 using records of asphyxiated babies in NICUs from January 1st, 2020 to December 31st, 2022, involving a sample size of 330. Pre-structured questionnaires created in Google Form were used to collect data, and STATA Version 14.0 was utilized for data entry and analysis, respectively. The Kaplan–Meier survival curve, log rank test, and median time were calculated. A multivariable Cox proportional hazards regression model was fitted in order to determine the predictors of time to recovery. Variables were statistically significant if their p-value was less than 0.05. Results Three hundred thirty admitted asphyxiated neonates were followed a total of 2706 neonate -days with a minimum of 1 day to 18 days. The overall incidence density rate of survival was 9.9 per 100 neonates’ days of observation (95% CI: 8.85–11.24) with a median recovery time of 9 days (95% CI: 0.82–0.93). Prolonged labor (Adjusted hazard ratio (AHR: 0.42,95%CI:0.21–0.81), normal birth weight (AHR:2.21,95% CI: 1.30–3.70),non-altered consciousness (AHR:2.52,CI:1.50–4.24),non-depressed moro reflex of the newborn (AHR:2.40,95%CI: 1.03–5.61), stage I HIE (AHR: 5.11,95% CI: 1.98–13.19),and direct oxygen administration via the nose (AHR: 4.18,95% CI: 2.21–7.89) were found to be independent predictors of time to recovery of asphyxiated neonates.. Conclusion In the current findings, the recovery time was prolonged compared to other findings. This implies early diagnosis, strict monitoring and provision of appropriate measures timely is necessary before the babies complicated into the highest stage of hypoxic –ischemic encephalopathy(HIE) and managing complications are the recommended to hasten recovery time and increase the survival of neonates.

Keywords

• Neonatal asphyxia
• Recovery time
• Neonatal intensive care unit
• Survival