Outcome and Associated Factors of Neonatal Surgeries at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, A 7-Year Period

Abstract

Introduction: Neonatal surgery is complex and time-sensitive, with a narrow margin for error. While neonatal surgical conditions account for approximately 11% of the global disease burden, data on their impact in Ethiopia remains limited. Methods: A hospital-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital by reviewing medical records of 268 neonates who underwent surgery between 2017 and 2023. Data were analyzed using Stata version 14. Multivariable logistic regression was used to identify predictors of mortality. Statistical significance was set at P < .05. Results: The overall mortality rate was 14.18%. Key predictors of mortality included preoperative sepsis (AOR: 4.45; 95% CI: 1.49-13.27), postoperative hypothermia (AOR: 3.19; 95% CI: 1.17-8.71), low birth weight (AOR: 3.7; 95% CI: 1.12-12.43), preterm birth (AOR: 3.88; 95% CI: 1.04-14.46), and prolonged hospital stay (AOR: 3.34; 95% CI: 1.15-9.84). Conversely, neonates aged 9 to 28 days had significantly lower odds of death (AOR: 0.22; 95% CI: 0.05-0.998). Conclusion: Neonatal surgical mortality was significantly influenced by preoperative, intraoperative, and postoperative factors. Targeted interventions focusing on infection control, thermal regulation, and care of preterm and low birth weight neonates may improve outcomes.