الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Neonatal mortality is of great concern. In both the developing and developed worlds, the neonatal mortality rate is an important indicator of demographic characteristics, health care level, and developmental progress.
Nations continuously adapt protocols and guidelines in order to decrease mortality rates to the least number possible. Among all children’s mortality rates, neonatal rate is the crucial one. While under 5-year childhood mortality has steadily declined worldwide, the neonatal mortality rate is decreasing so slowly. Attention and analysis should be targeted to this slow decrease.
Improved registration and increasing the availability and use of relevant information for decision makers is important step in order to decrease mortality rates. According to the World Bank neonatal mortality rate in Egypt was last measured at 12.8 per 1000 live births in 2016.
Studying factors affecting neonatal mortality commonly reveals that most of them are intimately linked with maternal health and health facility levels.
Previous studies have shown that neonatal mortality is influenced by multiple factors; Maternal health before, during, and after pregnancy, conditions at the time of labor , delivery and postnatal care of babies ,preterm birth complications, infections, intrapartum related causes, infant size and place of delivery, socioeconomics, demographics, and the health care system. Cultural practices and technology are also important indirect determinants of neonatal mortality.
Risk scoring systems have driven a wide range of applications, including; assessing quality of care provided by hospitals and physician ”quality assurance programs” ,triaging patients to appropriate services, cost effectiveness analyses , benchmarking ICU performance, to monitor the effects of changes in practice (by observing trends within units over time), to assess the relationship between severity of illness and length-of-stay or cost, to monitor the effects of rationing intensive care, clinical decision making stratification for research trials and pediatric trauma outcomes.
The general objective of this study was to construct prediction model for neonatal mortality in neonatal intensive care unit of one of Ministry of Health and Population pediatric hospital in Alexandria.
The study included two phases; first phase was a longitudinal descriptive study to determine the in-hospital mortality rate. All records were reviewed to calculate NICU’s mortality rate for neonates admitted to the selected NICU during years 2015-2016.
The second phase was a nested case control study to determine risk factors associated with in-hospital neonatal mortality and to be used for construction of the prediction model.
Sample size for the case control phase of the study was calculated to be 376 using an Odds Ratio of prematurity as the main risk factor for neonatal deaths =3.2 and the proportion of prematurity among the control population was 4.6% with a statistical power of 80% and α = 0.05. The sample size was calculated using Epi info 6 software and was rounded to be 400(200 cases and 200 controls).The collected data were statistically analyzed by SPSS program version 21.
The in-hospital neonatal mortality percentage of the neonates admitted to the studied NICU during years 2015-2016 was 16.4%.the main significant predictors for in-hospital neonatal mortality were prematurity (OR=6.4), small for gestational age (OR=5.1), pneumonia(OR=8.06), congenital anomalies (OR=50.97), need for mechanical ventilation(10.34), RBC count(OR=0.56).