Risk factors of respiratory distress among newborns admitted to the neonatal intensive care unit at public hospitals of addis ababa, Ethiopia. unmatched case-control study

Abstract

BACKGROUND: Respiratory distress (RD) is a common cause of neonatal morbidity and mortality globally, particularly in resource-limited settings. Although standard management exists in the neonatal intensive care unit, the determinants are not well understood. Therefore, this study aimed to identify the risk factors for respiratory distress among newborns admitted to NICUs in selected public hospitals in Addis Ababa, Ethiopia, in 2024. METHODS: An institution-based unmatched retrospective case-control study was conducted at selected public hospitals in Addis Ababa from March 1 to April 1, 2024. Systematic random sampling was used to select the cases and controls. Data were collected through face-to-face interviews using a structured, pre-tested questionnaire for mothers (Informed consent was obtained from each mother through written and oral explanations), and a data extraction checklist for mothers and neonatal medical records. Data were collected using the Kobo Toolbox (Harvard Humanitarian Initiative, Cambridge, MA, USA), and the collected data were exported to the Statistical Package for the Social Sciences (SPSS) software version 26 for analysis. Binary logistic regression was used for both bi-variable and multivariable analyses, and statistical significance was set at p < 0.05. RESULTS: In this study, 489 neonates and their mothers were included, yielding a 100% response rate. Emergency cesarean section (AOR = 3.074, 95% CI: 1.016-9.302), meconium-stained amniotic fluid (AOR = 5.103, 95% CI: 1.739-14.974), low birth weight (< 2500 g) (AOR = 3.592, 95% CI: 1.293-9.978), and low first-minute Apgar score < 7 (AOR = 9.693, 95% CI: 3.945-23.817) were identified as predictors of respiratory distress. CONCLUSION: Emergency cesarean section, meconium-stained amniotic fluid, low birth weight, and low first-minute Apgar score were identified as determinants of respiratory distress. Monitoring during labor and delivery and prompt and effective neonatal resuscitation may reduce respiratory distress.