Incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first seven days in Northwest Ethiopia Comprehensive Specialized Hospitals, 2023: A retrospective follow-up study.

INTRODUCTION: Respiratory distress syndrome is a catastrophic respiratory problem among low birth weight neonates. It increases the suffering of neonates and the economic expenditure of the countries. Notably, it is a major public health issue in low-income and middle-income countries such as Ethiopia. Despite this, studies regarding respiratory distress syndrome among low birth weight neonates were limited in Ethiopia. OBJECTIVE: To assess the incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first 7 days in Northwest Ethiopia Comprehensive Specialized Hospitals. METHOD: Multicentred institution-based retrospective follow-up study was conducted from 19 September 2021 to 1 January 2023, among 423 low birthweight neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.6. and analysed using STATA V.14. The Kaplan-Meier failure curve and log-rank test were employed. Bivariable and multivariable Weibull regression was carried out to identify predictors of respiratory distress syndrome. Statistical significance was declared at a p≤0.05. RESULT: The incidence rate of respiratory distress syndrome was found to be 10.78 (95% CI 9.35 to 12.42) per 100 neonate days. Fifth minute Appearance, Pulse, Grimace, Activity, Respiration (APGAR score) <7 (AHR 1.86; 95% CI 1.18 to 2.92), multiple pregnancy (AHR 1.43; 95% CI 1.04 to 1.96), caesarean section delivery (AHR 0.62; 95% CI 0.41 to 0.93), prematurity (AHR 1.56; 95% CI 1.06 to 2.30) and birth weight <1000 g (AHR 3.14; 95% CI 1.81 to 5.40) and 1000-1499 g (AHR 2.06; 95% CI 1.42 to 2.83) were significant predictors. CONCLUSION: The incidence of respiratory distress syndrome was higher than other studies conducted on other groups of neonates. Multiple pregnancy, fifth minute APGAR score, caesarean section, prematurity, extremely low birth weight and very low birth weight were predictors of respiratory distress syndrome. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention for these predictors.

Prevalence of Exclusive Breast Milk Feeding at Discharge and Associated Factors Among Preterm Neonates Admitted to a Neonatal Intensive Care Unit in Public Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Studies show that rates of breast milk feeding are much lower among preterm infants than term infants, and breast milk feeding at discharge varies widely between countries. However, research examining factors associated with exclusive breast milk feeding at discharge among preterm neonates in Ethiopia is limited. The study aimed to assess the prevalence of exclusive breast milk feeding at discharge and associated factors among preterm neonates at the neonatal intensive care unit (NICU) in public hospitals, Addis Ababa, Ethiopia. METHODS: This facility-based cross-sectional study was conducted from February to March 2017 among preterm infants discharged from the NICU of public hospitals. Data were collected using pretested structured questionnaires. Purposive sampling technique was used. Factors associated with exclusive breast milk-fed infants at discharge among preterm neonates were determined using bivariate and multivariate logistic regression models. Statistically significant associations were declared at P<0.05. RESULTS: The study assessed 263 mother-preterm dyads. The findings from this study revealed that 71.9% of exclusive breast milk-fed infants at discharge at NICU of the selected Public hospitals in Addis Ababa. Factors associated with exclusive breast milk-fed infants at discharge included duration of hospital stay for 7-14 days (AOR 0.19, 95% CI 0.049-0.808) and more than 14 days (AOR 0.20, 95% CI 0.046,0.891), Initiation of breast milk expression later than 48 hrs postpartum (AOR 0.10, 95% CI 0.032-0.365) and receiving hospital support (AOR 39.00, 95% CI 11.676-130.290). CONCLUSION: In this study, nearly ¾ of the NICU premature population exclusively breast milk fed at discharge, which designates to establish exclusive breastfeeding in the majority of preterm infants in this cohort. Thus, support for exclusive breast milk fed should be at the forefront of maternity practice in hospital and mothers of preterm infants to be guided to initiation of early breast milk expression as soon after delivery as possible and frequent expression thereafter.