Observational studyThe Lancet. Global health2019
Major causes of death in preterm infants in selected hospitals in Ethiopia (SIP): a prospective, cross-sectional, observational study.
Observational study in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 116 papers, 5 of them syntheses that pooled it.
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Who cites it
116 citing papers in PubMed, 5 syntheses or guidelines pooled it, 196 citations in OpenAlex.
- Prevalence of neonatal necrotizing enterocolitis and predictors in Ethiopia: a systematic review and meta-analysis.International health · 2026Pooled it
- Global inequities in the survival of extremely preterm infants: a systematic review and meta-analysis.BMC pediatrics · 2025Pooled it
- Outcome Reporting in Clinical Trials on Kangaroo Mother Care in Newborns: A Systematic Review for the Development of Core Outcome Set.Journal of nursing management · 2025Pooled it
- Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Effect of Preterm Birth on the Risk of Adverse Perinatal and Neonatal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Neonatal Mortality and Its Associated Factors Among Neonates in Ethiopia: A Systematic Review and Meta-Analysis.Public health challenges · 2026Article
- Article
- A machine learning approach to identify key socio-economic and demographic factors associated with neonatal mortality in Ethiopia.BMC public health · 2026Article
- Bacterial pathogens and antimicrobial resistance patterns in infections associated with stillbirths and under-five deaths in Ethiopia: a post-mortem surveillance study.BMC infectious diseases · 2026Article
- Morbidity patterns, mortality, and antimicrobial resistance among children hospitalized in neonatal and pediatric intensive care units in a rural area of Vietnam.IJID regions · 2026Article
- Readiness to Provide Neonatal Care Services in 208 Ethiopian Hospitals Prior to Implementation of the Saving Little Lives Program.Children (Basel, Switzerland) · 2026Article
- Preterm Neonatal Mortality and Its Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis.Health science reports · 2026Review
- Article
- Saving Little Lives Minimum Care Package Interventions in 290 Public Health Facilities in Ethiopia: Protocol for a Non-Randomized Stepped-Wedge Cluster Implementation Trial.Children (Basel, Switzerland) · 2026Article
- Health system readiness for immediate Kangaroo Mother Care (iKMC) among network of care facilities in the Sidama region, Ethiopia: a mixed-method study.Gates open research · 2026Article
- Article
- Longitudinal analysis of fecal tryptophan metabolites and microbiome composition in very preterm infants: impact of birth mode and feeding type.Gut microbes · 2025Article
- Diagnostic accuracy of a simplified minimally invasive tissue sampling protocol for stillbirths in low-resource settings.BMJ global health · 2025Article
- Barriers to improving preterm newborn outcomes through effective antenatal corticosteroid use in Ethiopia.BMJ global health · 2025Article
- Risk prediction of healthcare-associated neonatal sepsis in Amhara, Ethiopia: A prospective cohort study.Global pediatrics · 2025Article
56 more citing papers are in PubMed but not listed here.
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Authors and funding
35 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeonatal deaths now account for 47% of all deaths in children younger than 5 years globally. More than a third of newborn deaths are due to preterm birth complications, which is the leading cause of death. Understanding the causes and factors contributing to neonatal deaths is needed to identify interventions that will reduce mortality. We aimed to establish the major causes of preterm mortality in preterm infants in the first 28 days of life in Ethiopia.
methodsWe did a prospective, cross-sectional, observational study in five hospitals in Ethiopia. Study participants were preterm infants born in the study hospitals at younger than 37 gestational weeks. Infants whose gestational age could not be reliably estimated and those born as a result of induced abortion were excluded from the study. Data were collected on maternal and obstetric history, clinical maternal and neonatal conditions, and laboratory investigations. For neonates who died of those enrolled, consent was requested from parents for post-mortem examinations (both complete diagnostic autopsy and minimally invasive tissue sampling). An independent panel of experts established the primary and contributory causes of preterm mortality with available data.
findingsBetween July 1, 2016, to May 31, 2018, 4919 preterm infants were enrolled in the study and 3852 were admitted to neonatal intensive care units. By 28 days of post-natal age, 1109 (29%) of those admitted to the neonatal intensive care unit died. Complete diagnostic autopsy was done in 441 (40%) and minimally invasive tissue sampling in 126 (11%) of the neonatal intensive care unit deaths. The main primary causes of death in the 1109 infants were established as respiratory distress syndrome (502 [45%]); sepsis, pneumonia and meningitis (combined as neonatal infections; 331 [30%]), and asphyxia (151 [14%]). Hypothermia was the most common contributory cause of preterm mortality (770 [69%]). The highest mortality occurred in infants younger than 28 weeks of gestation (89 [86%] of 104), followed by infants aged 28-31 weeks (512 [54%] of 952), 32-34 weeks (349 [18%] of 1975), and 35-36 weeks (159 [8%] of 1888).
interpretationThree conditions accounted for 89% of all deaths among preterm infants in Ethiopia. Scale-up interventions are needed to prevent or treat these conditions. Further research is required to develop effective and affordable interventions to prevent and treat the major causes of preterm death.
fundingBill & Melinda Gates Foundation.
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