BACKGROUND The first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. In Ethiopia, despite a significant reduction in under-five mortality during the last 15 years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. METHODS A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan-Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates' survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. RESULT The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR = 3.643; 95% CI, 1.36-9.77), male neonates (AHR = 2.71; 95% CI, 1.03-7.09), neonates that mothers perceived to be small (AHR = 3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after 1 h (AHR = 3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR = 3.07; 95% CI, 1.16-8.12). CONCLUSION Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

中文翻译：

---

埃塞俄比亚南部阿罗雷萨地区的新生儿存活率和死亡率决定因素：一项前瞻性队列研究。

背景技术存活的头28天是儿童持续性生活中提到的最大挑战。在埃塞俄比亚，尽管在过去15年中五岁以下儿童的死亡率已大大降低，但新生儿死亡率仍然是一个公共卫生问题，占五岁以下儿童死亡率的47％。了解新生儿存活率和新生儿死亡的危险因素可能有助于设计有针对性的干预措施。这项研究的目的是确定埃塞俄比亚南部阿罗雷萨地区的新生儿存活率和新生儿死亡的危险因素。方法在2018年1月1日至2018年3月30日分娩的足月妊娠母亲和新生儿队列中进行了基于社区的前瞻性随访研究。通过多阶段抽样技术，共选择了586名足月妊娠母亲，对584例新生儿进行了为期28天的随访，其中包括12对双胞胎。使用SPSS 22版对数据进行编码，输入，清理和分析，使用Kaplan-Meier生存曲线显示28天新生儿死亡的模式。使用Cox回归模型评估了不同预测因素与新生儿生存的独立和调整的关系。探索了死亡风险，并以危险比和95％置信区间和P值小于0.05的显着性表示。结果整体新生儿死亡率为每1000例活产41例。患有并发症的新生儿（AHR = 3.643; 95％CI，1.36-9.77），男性新生儿（AHR = 2.71; 95％CI，1.03-7.09）的新生儿死亡风险很高，母亲认为自己较小的新生儿（AHR = 3.46; 95％CI，1.119-10.704），在1小时后开始纯母乳喂养（EBF）的新生儿（AHR = 3.572; 95％CI，1.255-10.165）和母亲没有产后护理（AHR = 3.07; 95％CI，1.16-8.12）。结论研究区域的新生儿死亡率为4.1％，很高，应立即采取行动实现可持续发展目标。为了提高新生儿的生存率，建议采取有影响力的干预措施，例如提高产妇服务水平，必要的新生儿护理和尽早开始纯母乳喂养。结论研究区域的新生儿死亡率为4.1％，很高，应立即采取行动实现可持续发展目标。为了提高新生儿的生存率，建议采取有影响力的干预措施，例如提高产妇服务水平，必要的新生儿护理和尽早开始纯母乳喂养。结论研究区域的新生儿死亡率为4.1％，很高，应立即采取行动实现可持续发展目标。为了提高新生儿的生存率，建议采取有影响力的干预措施，例如提高产妇服务水平，必要的新生儿护理和尽早开始纯母乳喂养。