Trends and predictors of in-hospital survival among asphyxiated neonates admitted at Kilimanjaro Christian Medical Center, Northern Tanzania: Retrospective Cohort Study

Abstract

Background: Globally about 9 million neonates are diagnosed with birth asphyxia yearly. In Tanzania 40.6% of all neonatal deaths are attributed to birth asphyxia. There is scarcity of evidence on predictors of in-hospital survival among asphyxiated neonates in Tanzania, therefore study aimed to determine trends and predictors of survival among neonates who sustained birth asphyxia at Kilimanjaro Christian Medical Center, Northern Tanzania. Method and materials: This was a hospital-based retrospective cohort study, conducted at Kilimanjaro Christian Medical Center among 7,783 admitted asphyxiated neonates from 2000 to 2022. The predictors of survival were determined by using the Weibull survival regression model and the statistically significant results were declared at a p-value of <.05. Data were managed and analyzed using Stata 18. Results: Overall finding from this study showed significant increase in the trends of survival from birth asphyxia from 2000 to 2022, from 68% to 80% respectively (p-value<.001). The median survival time was 4days (95% CI:3.0-6.0). Overall survival rate was 195.32/1000 person-days-of observation (95% CI: 190.57, 200.18). Antenatal care (ANC) stages (AHR: 0.74; 95% CI: 0.62-0.89), gestation age (AHR: 0.81; 95% CI: 0.76-0.86), birth weight (AHR: 1.19; 95% CI: 1.12-1.26), mode of delivery (AHR: 1.69; 95% CI: 1.60-1.78), Aminophylline (AHR: 1.56; 95% CI: 1.52- 1.60), oxygen (AHR: 1.32; 95% CI: 1.23-1.42), resuscitation (AHR: 1.32; 95% CI: 1.24-1.42) and HIE(AHR: 1.85; 95% CI: 1.79-1.91) were all independent significant predictors of survival. Conclusion: There is a need for health professionals to remain vigilant and promptly assess and stabilize the airway, breathing, and circulation, initiate resuscitation, provide oxygen, administer medications such as aminophylline to neonates who are diagnosed with birth asphyxia.