Survival and Predictor of Thrombocytopenic Neonatal Death in Public Hospitals of Addis Ababa, Ethiopia, 2025: Multicenter Prospective Follow Up Study

ABSTRACT Background Globally, thrombocytopenia is one of the most common hematologic conditions seen in ill neonates. In countries with limited resources, like Ethiopia, it is a serious concern. Because the burden of thrombocytopenia is so great, generating updates evidence on predictors of mortality and survival status is vital to fight it. However, the problem is not well investigated in Addis Ababa. Therefore, this study aimed to assess survival and predictor of thrombocytopenic neonatal death in Public Hospitals, Addis Ababa, Ethiopia, 2024/2025. Methods and Materials A prospective follow-up study was done among a total of 350 neonates from March 20, 2025, to April 30, 2025, in Addis Ababa public hospitals. All thrombocytopenic neonates that meet the inclusion criteria were chosen as study participants. Data were collected using the Kobo Tool through direct observation and review of maternal and neonatal charts. After export to an Excel spreadsheet, data cleaning and recoding were performed using SPSS version 26, followed by statistical analysis using STATA version 17. The Kaplan-Meier failure curve was used to demonstrate the pattern of death, estimate the chance of death, and compare failure curves. Collinearity, Schoenfeld residual, and log-rank tests were performed. The Cox proportional hazards model was fitted with global test result of 0.7882. Finally, the findings were presented both descriptively and analytically. Results In this study, the overall magnitude of thrombocytopenic neonatal death was 14.1% (95% CI: 10.4–18.1), with an incidence rate of 13.04/1000 (95% CI: 0.009–0.017) neonate-days. The restricted mean time to death in this study was 23.36 days (95% CI: 22.23–24.50). Being born to a mother with severe preeclampsia (AHR = 3.84; 95% CI: 1.78–8.26), very low birth weight (<1499g) (AHR = 3.67; 95% CI: 1.14–11.80), perinatal asphyxia (AHR = 2.76; 95% CI: 1.32–5.79), necrotizing enterocolitis (AHR = 2.45; 95% CI: 1.14–5.31), and delayed initiation of feeding (AHR = 3.37; 95% CI: 1.10–10.29) were the identified predictors of mortality. Conclusion and recommendation In this study, a high burden of thrombocytopenic neonatal death. Early detection and treatment of high-risk conditions like severe preeclampsia, very low birth weight, perinatal asphyxia, and necrotizing enterocolitis should be the main goal of efforts to lower thrombocytopenic neonatal mortality. Furthermore, prompt neonatal feeding initiation ought to be given top priority.