Abstract:
Background: Respiratory distress syndrome is a major factor in both morbidity and mortality among
newborns worldwide. Studies related to the survival status and predictor mortality of neonate with
respiratory distress syndrome were limited. Therefore, this study was aimed to assess the survival status
and predictors of mortality among neonates admitted with respiratory distress syndrome.
Objective: To assess the survival status and predictors of mortality among neonates admitted with
respiratory distress syndrome in the neonatal intensive care units of comprehensive specialized hospitals
in the East Amhara region, Ethiopia, 2023.
Methods: An institution-based retrospective follow-up study was conducted among 494 neonates with
respiratory distress syndrome admitted to the neonatal intensive care units, by review chart from
December 1, 2018, to December 31, 2022 through a structured data extraction tool. Systematic random
sampling method used to select study participants. The data were entered into Epi Data version 4.6 and
analyzed with STATA version 14.0. Life table were used to estimate median survival time. Kaplan Meier and Log-rank test were used to compare the survival status between the covariates and whether
the covariates are statistically difference or not respectively. Cox Proportional Hazard regression model
was performed. Adjusted hazard ratio with a 95% confidence interval and p-values < 0.05 was used to
measure the strength of association and to identify statistical significance. Cox-Snell residual and the
Schoenfeld residual test were used to evaluate the model's goodness of fit and assumptions.
Results: The overall median survival time was 13 days, with an overall cumulative survival probability
of death 42.31 %( 95%CI: 0.37, 0.46). The overall incidence rate of mortality was 60.19 per 1000 (95%,
CI: 52.56, 68.93) with 3472 person-days of observation. Birth weight<2500 gram (AHR:1.48
(95%CI:1.01,2.16), perinatal asphyxia (AHR1.41(95% CI:1.06,1.89), hypothermia (AHR:1.36 (95%CI:
1.01,1.83), caesarian section delivery (AHR: 1.59 (95% CI: 1.12, 2.25), abruption placenta
(AHR:2.09(95% CI:1.06,4.12) ,vasa Previa (AHR:5.89(95% CI:2.26,15.30),preeclampsia (AHR:1.69
(95% CI:1.07,2.68) were a statistically significant predictor of mortality of respiratory distress
syndrome neonates.
Conclusion: Respiratory distress syndrome in newborn has come to a standstill as a major public health
issue and being low Birth weight, perinatal asphyxia, hypothermia, and abruption placenta, vasa Previa,
preeclampsia, and caesarian section delivery were significant predictors of mortality of neonates with
respiratory distress syndrome. Hence, giving special attention to patients with identified predictors
should be better.
