Factors associated with early neonatal mortality among low birth weight babies in Jinja Regional Referral Hospital, Uganda.

Abstract

Introduction: In the Uganda, Low Birth Weight attributes to 15.3% neonatal mortality. Over 85% of all neonatal deaths occur in the first week of life and about 95% of low birth weight neonatal deaths occur in the first week of life (Arunda et al., 2018). It is therefore, necessary that recommendations to reduce mortality among Low Birth Weight (LBW) babies are identified and prioritized by hospitals in resource limited settings. Objective The main objective of this study was to determine factors associated with early neonatal mortality among LBW babies in Jinja Regional Referral Hospital. Methods To determine factors associated with early neonatal mortality among LBW babies in Jinja Regional Referral Hospital, an unmatched case control study design was used. A total of 228 LBW babies were included in the study whereby 76 cases and 152 controls were consecutively sampled. Health records were reviewed and semi structured questionnaires were used. To assess for the association between neonatal factors, maternal factors and health system factors associated with early neonatal mortality among LBW babies, crude odds ratio with 95% confidence interval were performed. Variables with p-value <0.05 were identified as factors associated with early neonatal mortality among LBW babies in the multivariable analysis. Results The study found out that maternal factors comprised of: - antenatal care visits less than 4 AOR (3.421) 95% CI (1.092 - 10.714), not attending ANC AOR (3.413) 95% Cl (1.250 - 9.316), having hypertension during pregnancy AOR (6.910) 95%CI (2.085 - 22.897), rural residence AOR (5.940) 95% Cl (2.410 -14.706) and drinking alcohol during pregnancy AOR (3.466) 95% Cl (1.256 - 7.531) had statistically significant associations with early neonatal mortality among LBW babies. In addition to that it reported that gestational age of 28-32 weeks AOR (5.972) 95% Cl (1.259 - 28.320), gestational age of less than 28 weeks at delivery AOR (18.982) 95%CI (3.069 -117.403), birth order of 4 and above AOR (6.607) 95% CI (1.802 - 24.226), Apgar score 12 at 5 minutes of 5 to 7 AOR (2.781) 95% CI (1.055 - 7.333) and Apgar score at 5 minutes of less than 5 AOR (4.254) 95% Cl (1.091 -16.587) had statistically significant associations with early neonatal mortality among LBW babies. Health system factors: - not having a functional intensive care unit at place of delivery AOR (3.466) 95% Cl (1.166 -10.305), neonate not put in NICU AOR (5.140) 95% CI (1.735 - 15.222), not being seen by a specialist AOR (3.503) 95% Cl (1.049 - 8.527) had statistically significant association with early neonatal mortality among LBW babies. Conclusion The factors that had statistically significant associations with early neonatal mortality among LBW neonates were; antenatal care visits less than 4 or none, having hypertension during pregnancy, rural residence, drinking alcohol during pregnancy, gestational age of 28-32 weeks and also less than 28 weeks at delivery, birth order of 4 and above, birth asphyxia, not having a functional intensive care unit at place of delivery, neonate not placed in NICU and not seen by a specialist.The study is useful in identifying underlying factors associated with early neonatal mortality among LBW babies. Consequently, it will assist in formulating preventive and curative interventions that will address these factors among this vulnerable population.