Abstract:

Background: The neonatal period, life is the most vulnerable period for a child’s survival, and as a result has high rates of morbidity and mortality. According to the World Health Organization, of estimated 130 million infants born each year worldwide, 4 million dies in the first 28 days of life and half of neonatal deaths occur within the first 24 hours of life. This study aims to assess the patterns of admission and factors associated with neonatal mortality in among neonates admitted at Bugando Medical Centre

Method: This was a retrospective cross-sectional study that was conducted at Bugando Medical Centre Data was retrieved from the Electronic Health Management System (EHMS). A structured questionnaire was used to collect social demographic and clinical information. Data was entered in Excel and analysed using SPSS version 20, and p-values <0.05 were considered statistically significant

Results: A total of 210 neonates were included in the study. 64.8% were born preterm, 31.9% at term and 3.3% post term. 73.8% of them had a birth weight <2500g at birth, 22.4% had a birth weight 2500-3900g, and among them 66.7% were females and 33.3% were males, 78.1% were from urban area and 21.9% were from rural areas. 76.7% of them were delivered at a tertiary hospital with the remaining being referred from either home, health centre, district or regional hospital. 63.8% of the population were admitted within 24 hours, 30% between 24 hours and 7 days, 46.7% were admitted due to respiratory distress, 19.0% due to birth asphyxia, 17.1% due to early onset sepsis and the rest due to neonatal jaundice, meconium aspiration, intrauterine growth restriction and big babies. Multiple factors associated with mortality of neonates admitted at NICU were assessed where there was a statistically significant association between gestational age and neonatal mortality (p-0.03) where preterm neonates were found to have the highest mortality rate, also there was a correlation between birth weight and higher mortality rates (p-0.04) where those born with weight <2500g have higher mortality rates compared to those with weight >2500g. Admission time also shows a potential association with neonatal mortality, with shorter admission times (within 24 hours) possibly linked to higher mortality, though this result is close to the significance threshold (p-0.05). the reason for admission is significantly associated with neonatal mortality (p-0.045), with high-risk admissions like respiratory distress, neonatal sepsis and birth asphyxia) showing a higher mortality rate compared to low-risk admissions like big baby

Conclusion: Respiratory distress, neonatal sepsis and birth asphyxia were the main reasons for NICU admission. Neonates often died within the first 24 hours of age so timely intervention could decrease neonatal mortality at Bugando Medical Centre