Neonatal mortality and associated factors among preterm neonates admitted to Jigjiga University Sheikh Hassan Yabare Comprehensive Specialized Hospital, Ethiopia: A retrospective cross-sectional study
This retrospective cross-sectional study conducted in Jigjiga, Ethiopia, found a 30.3% mortality rate among admitted preterm neonates, identifying low birth weight, low APGAR scores, and hypothermia as significant risk factors, while resuscitation at birth, kangaroo mother care, and early feeding initiation were protective factors.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every year, millions of babies are born before their bodies are fully ready for the world. In medical terms, a baby born before thirty-seven weeks of pregnancy is called preterm. Because their organs, especially their lungs and skin, have not finished developing, these infants face a much harder fight for survival than babies born at full term. They are more likely to struggle with breathing, get infections, or have trouble keeping their body temperature steady. While doctors in wealthy nations have many tools to help these fragile newborns, the situation is often far more difficult in lower-income countries, where resources are scarce and the stakes are life and death. Understanding exactly which factors help or harm these tiny patients is the only way to save more of them.
In the Somali region of eastern Ethiopia, researchers recently looked back at the records of preterm babies admitted to a major university hospital to see what happened to them and why. The team focused on the Jigjiga University Sheikh Hassan Yabare Comprehensive Specialized Hospital, a large facility that serves millions of people in the region and neighboring areas. Between early 2024 and early 2026, they reviewed the files of every preterm infant who had been admitted to the newborn intensive care unit during that time. After removing records that were incomplete or where the baby was sent away before the study could be finished, they analyzed the data for 412 babies. Their goal was simple: to find out how many of these infants died and to identify the specific conditions or treatments that made the difference between life and death.
The results painted a stark picture. Out of the 412 preterm babies studied, nearly one in three did not survive their first month of life. This rate of 30.3 percent is high, though it aligns with findings from other hospitals in similar settings across Africa. The researchers found that the babies who died were not a random group; they shared specific characteristics that pointed to where care could be improved. The most critical factor was how small the baby was at birth. Infants weighing less than 1,500 grams were more than three times as likely to die as those who were slightly heavier. Similarly, babies who had a low score on a standard health check taken five minutes after birth, which measures how well they are breathing and moving, faced a much higher risk of death.
Beyond the baby's size and initial condition, the care they received in the hospital played a massive role. The study showed that when a baby became too cold while in the hospital, their chances of survival dropped dramatically. Keeping a preterm infant warm is not just about comfort; it is a matter of survival because their bodies cannot regulate temperature on their own. On the other hand, certain interventions acted as powerful shields against death. Babies who received immediate help to start breathing right after birth were significantly more likely to survive than those who did not. Perhaps most surprisingly, the study found that babies who were placed in continuous skin-to-skin contact with their mothers, a method known as kangaroo mother care, were far less likely to die. This simple practice, which involves holding the baby against the parent's chest, helps regulate the infant's temperature and heart rate while encouraging breastfeeding.
The timing of feeding also mattered greatly. Babies who were able to start eating within the first twenty-four hours of life had a much lower risk of death compared to those whose feeding was delayed. The researchers noted that early feeding helps protect the baby from infections and keeps their blood sugar stable. While the study could not track every single detail of every mother's life or every medical decision made, the patterns were clear. The babies who survived were generally those who were kept warm, fed early, held close to their mothers, and helped to breathe immediately after birth.
This research does not claim to have solved the problem of preterm mortality, but it offers a clear map for where to focus efforts. The author suggests that improving survival rates in this region requires a concerted push to ensure that every preterm baby receives resuscitation at birth, is kept warm to prevent hypothermia, and is placed in skin-to-skin care as soon as possible. They also emphasize the need for feeding to begin within the first day of life. While the study was limited to one hospital and relied on past records, which means some information was missing, the findings are strong enough to guide immediate action. By implementing these specific, proven practices, hospitals can move the needle from a high rate of tragedy toward a future where more of these fragile newborns grow up to thrive.
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