# Incidence and predictors of dehydration among preterm neonates admitted to the neonatal intensive care unit of Southern Ethiopia hospitals: A prospective follow-up study

## TL;DR

This study found a high rate of dehydration in preterm babies in Ethiopian hospitals and identified factors like phototherapy and nurse workload that increase the risk.

## Contribution

The study provides new evidence on dehydration incidence and its predictors in preterm neonates in Southern Ethiopia.

## Key findings

- The incidence of dehydration was 41 per 1000 patient-days in preterm neonates.
- Key predictors included phototherapy, incubator use, maternal hypertension, and nurse-to-patient ratio.
- Lack of regular dehydration assessment increased the risk of dehydration.

## Abstract

Dehydration is one of the causes of preterm morbidity and mortality. Many efforts are being implemented to decrease the cause of preterm mortality, but there is a gap regarding dehydration in generating research-supported evidence. Therefore, this study aimed to investigate the incidence and predictors of dehydration among preterm neonates admitted to the neonatal intensive care units of Southern Ethiopia hospitals.

A prospective, institution-based follow-up study was conducted among 363 maternal-preterm neonatal pairs. Data were collected using a checklist and entered into Epidata version 4.4.2.1, and analyzed using STATA version 14. Bi-variable and multivariable regression were computed using the Cox regression model. A statistical significance was declared at a p-value of <0.05 in line with a 95% confidence interval (CI) and hazard ratios.

This study was conducted among 363 maternal-neonatal pairs. The incidence of dehydration was 41 per 1000 patient-days, with a total of 3546 patient-days observed. Maternal hypertension (AHR) = 2.95, CI: 1.56, 5.58), phototherapy (AHR = 2.71, 95% CI: 1.37, 5.39), nurse to patient ration 1:2 (AHR = 2.62, 95% CI: 1.5, 4.6), kept in incubator (AHR = 3.38, 95% CI: 1.77, 6.45), asphyxia (AHR = 1.58, CI: 1.09–2.30) and absence of every four hour dehydration assessment (AHR = 1.62, CI: 1.42, 3.62) were predictors for incidence of dehydration among neonates admitted in NICU.

In this study, the incidence of dehydration among preterm neonates was high (41 per 1000 patient-days observation). The major associated factors were being under phototherapy, kept in an incubator, maternal hypertension, nurse-to-patient ratio, dehydration assessment practice, and asphyxia. So, establishing strategies on these identified predictor variables could be essential to reduce the suffering of preterm neonates’ dehydration.