Prevalence and associated factors of meconium aspiration syndrome among neonates admitted to Neonatal Intensive Care Units in Public Hospitals of Harari Region, Eastern Ethiopia

by Jabir Aman, Bikila Balis, Naol Oda, Dawit Tamiru, Tadesse Gure Eticha, Dawit Firdisa, Aboma Motuma

Background

Meconium aspiration syndrome is a life-threatening respiratory disease affecting around 5% of neonates worldwide. Although several studies have been conducted in developed countries, data on meconium aspiration syndrome and its associated factors remain limited in low-resource settings, including Ethiopia. Therefore, this study aimed to determine the meconium aspiration syndrome and associated factors among neonates admitted to the neonatal intensive care unit at public hospitals in Harari region, Eastern Ethiopia.

Method

A retrospective hospital-based cross-sectional study design was conducted among all neonates admitted from January 1 to December 30, 2023 and data were extracted from patient charts during April 1–30, 2025. A simple random sampling technique was employed to select 417 charts of neonates admitted to the neonatal intensive care unit. The data were collected by a data extraction checklist via Kobo Toolbox. Descriptive statistics and binary logistic regression were used in SPSS version 25 (IBM Corp., Armonk, NY, USA) for the analysis. Adjusted odds ratios with 95% confidence intervals were used to declare statistical significance at a p-value ≤ 0.05.

Results

The prevalence of meconium aspiration syndrome among neonates admitted to the neonatal intensive care unit was 24.2% [95% CI, 20.2–28.6]. Factors significantly associated with meconium aspiration syndrome were post-term gestation [AOR = 9.05, 95% CI 2.38–34.41], antepartum hemorrhage [AOR = 3.34, 95% CI 1.31–8.60], prolonged labor [AOR = 3.06, 95% CI 1.27–7.36], premature rupture of membranes [AOR = 3.65, 95% CI 1.28–10.45], low Apgar scores at 5th minute [AOR = 11.27, 95% CI 3.44–36.92] and intrapartum thick meconium passage [AOR = 5.98, 95% CI 2.6–13.6].

Conclusions and recommendations

These findings indicate a high prevalence of meconium aspiration syndrome, and to reduce its impact, targeted clinical interventions should be implemented. Pregnancies reaching 42 weeks of gestation, prolonged labor, and high-risk conditions such as antepartum hemorrhage, premature rupture of membranes, or the presence of thick meconium are important factors to consider. Careful monitoring and appropriate management may be warranted in these cases.

Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025

by Boru Abera Ebsa, Maleda Tefera, Dawit Tamiru, Abraham Negash, Naol Oda, Merga Dheresa

Background

The neonatal period is the most vulnerable time for an infant’s survival, particularly for preterm neonates. Preterm birth is among the leading causes of neonatal mortality. Many neonatal complications can be prevented, but preterm birth remains a leading cause of admission, death, and long-term complications, highlighting the need for further research on outcome and survival disparities across populations and settings. Therefore, this study aimed to assess survival status and predictors of mortality among preterm neonates admitted to neonatal intensive care units at public hospitals in the Harari region and Dire Dawa administration, Eastern Ethiopia, from November 1, 2021 to October 30, 2024.

Methods

The hospital-based retrospective cohort study was conducted among preterm neonates admitted to the neonatal intensive care unit at public hospitals of the Harari region and Dire Dawa administration, Eastern Ethiopia. A simple random sampling technique was used, and data were extracted from neonates’ medical records and registration formats using a structured checklist prepared in English. Descriptive statistics, life table, Kaplan-Meier curves, and Log-rank test were used to estimate and compare survival time. Predictors of mortality were identified using the Cox Proportional Hazard model.

Results

Out of 612 preterm neonates, 205 (33.5%; 95% CI: 29.76–37.39) died, corresponding to an incidence rate of 52.76 deaths per 1,000 preterm neonate-days (95% CI: 46.01–60.50), with a median survival time of 18 days. As multivariable cox-regression result,  ≥ 4 antenatal care contact (AHR = 0.56; 95% CI: 0.36–0.89), receiving KMC (AHR = 0.16; 95% CI: 0.09–0.27), 5th minute APGAR score Conclusion

The incidence of preterm neonatal mortality was high in this study. Adequate Antenatal care (ANC) and kangaroo mother care (KMC) significantly improved preterm survival, while low APGAR score, resuscitation with bag and mask, neonatal sepsis, PNA, and RDS were major predictors of preterm neonatal death. Emphasis should be placed on strengthening antenatal and perinatal care, along with early detection and management of identified neonatal complications.