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Introduction: The neonatal period refers to the first 28 days of life. Newborns are particularly vulnerable to death. The predictors associated with neonatal mortality need to be addressed, as identifying the predictors will contribute to reducing the rates of neonatal morbidity and mortality. Method: A facility-based retrospective cohort study was conducted of 332 records of neonates who were admitted to the neonatal intensive care unit at Arba Minch General Hospital. Data were collected from randomly selected neonate records using computer-generated random numbers. Data were entered into Epi-info version 3.5.1 and exported to SPSS v.23 for analysis. Crude hazard ratios, adjusted hazard ratios and 95% confidence intervals were used to assess the strength of association and statistical significance. The incidence density rate of death with respect to 'person time at risk' was calculated. Variables which had a p-value of ≤ 0.25 in bivariate analysis were considered as candidates for multivariate regression analysis; variables that had a p-value of ≤0.05 in the multivariate analysis were considered as independent predictors of neonatal mortality in the final Cox regression analysis. Result: The incidence density rate of neonatal mortality was 31.6 per 1,000 neonate days. The neonatal mortality predictors were 5th-minute APGAR score ≤5 (AHR: 1.9; 95%CI: 1.02,3.54); 2nd to 4th birth order (AHR:13; 95%CI: 5.1,33.4); 5th birth order (AHR:24; 95%CI: 10.5,55.2); history of two to four live births(AHR: 0.16; 95%CI: 1.07,3.63); history of ≥5 live births (AHR: 0.18; 95%CI: 0.06,0.51); and not initiating exclusive breastfeeding within the first hour of delivery (AHR: 1.8: 95%CI: 1.03,3.18). Conclusion: The incidence density rate of neonatal mortality was 31.6 per 1,000 neonate days, and maternal age, APGAR score, birth order, parity, and exclusive breastfeeding initiation were independent predictors of neonatal mortality

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ABSTRACT: There is always a concern about the survival of new-borns undergoing corrective surgical procedure early in life. Perioperative care, especially in sick babies, is challenging, and this makes ascribing outcomes to care given difficult. This study was aimed at determining and evaluating factors associated with poor outcomes in new-borns undergoing surgery and anaesthesia. This was a retrospective case notes review of 37 neonates who received general anaesthesia during surgical care over a three-year period. After ethical approval for the study, the demographic data, indications for surgery, American Society of Anesthesiologists' (ASA) classifications, preoperative, intraoperative and postoperative challenges present in these neonates as well as their outcome were extracted. A total of 48 neonates were operated over a three-year period, and only 37(77.1%) case files were available for review. Male: Female ratio was about 2:1, the two most common procedures performed were bowel resection and anastomosis in 7(18.9%) and colostomy 7(18.9%). Overall mortality was 29.7%. Neonatal mortality was significantly higher in patients with postoperative sepsis (p=0.006) and respiratory challenge (p=0.035). The median time to death was 9 days. Only one (9.1%) patient died within 24hours postoperative. Mortality in neonates undergoing surgical procedure early in life is very high in this study. However, it is difficult to implicate anaesthesia in our study as the cause of mortality as most occurred very late after many days of surgery. Availability of postoperative elective ventilation for selected patients may improve outcome

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Se realizó una investigación diseño observacional, longitudinal, prospectiva y descriptiva en la Unidad de Cuidados Intensivos Neonatales (UCIN) del Servicio de Neonatología del Hospital General Universitario Abel Santamaría Cuadrado en el período comprendido del 1/4/2006 hasta el 1/4/2007 con el objetivo de evaluar la morbimortalidad en el recién nacido quirúrgico (RNQ). El universo y la muestra coincidieron estando constituidos por los 13 nacidos vivos que ingresaron en la UCIN en el período establecido y que fueron sometidos a intervenciones quirúrgicas. Se analizaron variables como sexo, peso, edad gestacional, grado de crecimiento intrauterino, tipo de patología quirúrgica, diagnóstico prenatal, complicaciones y supervivencia. Se elaboró una base de datos en Epinfo versión 2002, y se aplicó el método porcentual para el análisis de los datos obtenidos. Existió un predominio del sexo masculino (61,5 por ciento), edad gestacional mayor de 40 semanas (46,1 por ciento) y un crecimiento adecuado para la edad gestacional (69,2 por ciento). La patología quirúrgica más frecuente fue el Onfalocele, seguido de la Atresia esofágica, Hernia diafragmática y Malformación anorrectal. Se realizó diagnóstico prenatal en el 50 por ciento de las Atresias esofágicas (1 caso), 100 por ciento de Hernias diafragmáticas (2 casos), no así en los 3 Onfalocele y la Atresia intestinal. Las complicaciones más frecuentemente encontradas fueron la sepsis de la herida (61,5 por ciento), dehiscencia de sutura (38,4 por ciento) y las complicaciones sistémicas (30,7 por ciento). Se logró una supervivencia del 76,9 por ciento...(AU)

An observational longitudinal, prospective and descriptive study was performed at the AntenatalIntensive Care Unit at Neonatal Service in Abel Santamaría Cuadrado General Hospital between April 1, 2006 and April 1, 2007 aimed at evaluating the morbidity and mortality rate inthe newborn underwent a surgery coinciding the universe and the sample and being comprised of13 newborns admitted at the Neonatal Intensive Care Unit during the established time and theyunderwent surgeries. The following variables were studied: sex, body weight, gestational age,and grade of intrauterine growth, kind of surgical condition, antenatal diagnosis, complicationsand survival. A Database was created in version 2002-Epinfo and the percentage method wasused for the analysis of data. Masculine sex was predominating (61.5 per cent), gestational age over 40weeks (46.1 per cent) and a proper growing to gestational age (69.2 per cent). The most frequent surgicalcondition was the omphalocele followed by oesophageal atresia, diaphragmatic hernia andanorectal malformation. An antenatal diagnosis was performed in 50 per cent of oesophageal atresias (1case), 100 per cent in diaphragmatic hernias (2 cases), but it did not in presence of omphalocele andintestinal atresia. The most frequent complications found were: wound sepsis (61,5 per cent), suturedehiscence (38,4 per cent) and the systemic complications (30.7 per cent). It was observed 76,9 per cent of survival...(AU)

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