{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:35:28Z","timestamp":1777656928455,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Pediatrics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Low-birth-weight (LBW) remains a leading cause of neonatal mortality in Ethiopia. This study aimed to identify individual and institutional determinants of mortality among LBW infants in Southern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A hospital-based prospective cohort study was conducted among 768 LBW neonates admitted to 8 public hospitals in South Ethiopia from September 2023 to February 2024. Data were collected using a structured questionnaire and analyzed using STATA 16. Multilevel logistic regression was applied to identify predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall mortality was 28.3%. Key individual-level predictors included lower birth weight, respiratory distress syndrome, necrotizing enterocolitis, and perinatal asphyxia. Institutionally, absence of isolated preterm rooms, inadequate physician staffing and distant NICU location significantly increased mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>LBW mortality in Southern Ethiopia is alarmingly high. Both clinical comorbidities and modifiable institutional factors, especially infrastructure and staffing, are critical determinants. Urgent improvements in neonatal care facilities and human resources are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/30502225251414623","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T16:51:52Z","timestamp":1772124712000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal Mortality in Low-Birth-Weight Infants in Southern Ethiopia: A Multicenter Cohort Study With Multilevel Analysis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2003-8933","authenticated-orcid":false,"given":"Jemberu","family":"Nigussie","sequence":"first","affiliation":[{"name":"Dilla University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8729-1784","authenticated-orcid":false,"given":"Fekadeselassie Belege","family":"Getaneh","sequence":"additional","affiliation":[{"name":"Wollo University, Dessie, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-3733","authenticated-orcid":false,"given":"Dires Birhanu","family":"Mihretie","sequence":"additional","affiliation":[{"name":"Dilla University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bekahegn","family":"Girma","sequence":"additional","affiliation":[{"name":"Dilla University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tewodros","family":"Mulugeta","sequence":"additional","affiliation":[{"name":"Dilla University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Endalk Birrie","family":"Wondifraw","sequence":"additional","affiliation":[{"name":"Wollo University, Dessie, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alemu","family":"Gedefie","sequence":"additional","affiliation":[{"name":"Wollo University, Dessie, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4161-3500","authenticated-orcid":false,"given":"Yibeltal Asmamaw","family":"Yitayew","sequence":"additional","affiliation":[{"name":"Wollo University, Dessie, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Getu Degu","family":"Alene","sequence":"additional","affiliation":[{"name":"Bahir Dar University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj-oh.2022.9.5.31289"},{"key":"e_1_3_3_3_2","author":"Kliegman R","year":"2020","unstructured":"Kliegman R, Geme JS, Stanton B, Schor N, eds. (eds) Nelson Textbook of Pediatrics. 21th ed. Elsevier; 2020.","journal-title":"Nelson Textbook of Pediatrics"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30565-5"},{"key":"e_1_3_3_5_2","author":"Tesfaye N","year":"2021","unstructured":"Tesfaye N. Clinical Reference Manual for Advanced Neonatal Care in Ethiopia. Federal Democratic Republic of Ethiopia, Ministry of Health; 2021.","journal-title":"Clinical Reference Manual for Advanced Neonatal Care in Ethiopia"},{"key":"e_1_3_3_6_2","unstructured":"Hug L Liu Y Nie W et al. Levels & Trends in Child Mortality. Report 2023. 2024. https:\/\/data.unicef.org\/resources\/levels-and-trends-in-child-mortality-2024\/"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(13)60993-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-12-S2-S6"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/23333928221117364"},{"key":"e_1_3_3_10_2","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. World Health Statistics. World Health Organization (WHO); 2017.","journal-title":"World Health Statistics"},{"key":"e_1_3_3_11_2","author":"World Health Organization","year":"2022","unstructured":"World Health Organization. WHO Recommendations for Care of the Preterm or Low-Birth-Weight Infant. World Health Organization (WHO); 2022.","journal-title":"WHO Recommendations for Care of the Preterm or Low-Birth-Weight Infant"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-18234-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt109"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2214.2001.00203.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028744"},{"key":"e_1_3_3_16_2","author":"Victor A","year":"2022","unstructured":"Victor A, Wesley I, Aguiar O, et al. Social inequalities in child development: analysis of low-birth-weight trends in Brazil, 2010-2020. J Prev. 2022.","journal-title":"J Prev"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2022.e10389"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0314632"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-04319-0"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-054574"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.08.006"},{"key":"e_1_3_3_22_2","author":"Fmoh E.","year":"2021","unstructured":"Fmoh E. Clinical Reference Manual for Advanced Neonatal Care in Ethiopia Ministry of Health 2021. Ministry of health; 2021.","journal-title":"Clinical Reference Manual for Advanced Neonatal Care in Ethiopia Ministry of Health 2021"},{"key":"e_1_3_3_23_2","author":"Chuan PTC","year":"2001","unstructured":"Chuan PTC. Guidelines for Hospitals with Neonatal Intensive Care Service: Regulation 4 of the Private Hospitals and Medical Clinics Regulations. Minster of Health; 2001.","journal-title":"Guidelines for Hospitals with Neonatal Intensive Care Service: Regulation 4 of the Private Hospitals and Medical Clinics Regulations"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e07256"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2020-000918"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2016.00023"},{"key":"e_1_3_3_27_2","volume-title":"Preventing Low Birthweight","author":"Behrman RE","unstructured":"Behrman RE, Harris JE, Hobel CJ, Klein JO, Luella Klein MCM. Preventing Low Birthweight. National Academy Press; 1985."},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.14238\/pi62.3.2022.186-91"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.114"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04012-z"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2021-323310"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/1824-7288-40-S2-A4"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","unstructured":"Horn AR Swingler GH Harrison MC et al. Defining hypoxic ischemic encephalopathy in newborn infants: benchmarking in a South African population. J Perinatal Med. 2012;41(2):211-217. doi:10.1515\/jpm-2012-0107","DOI":"10.1515\/jpm-2012-0107"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100388"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd012458"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0559"}],"container-title":["Sage Open Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/30502225251414623","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/30502225251414623","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/30502225251414623","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:07:38Z","timestamp":1777446458000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/30502225251414623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":35,"alternative-id":["10.1177\/30502225251414623"],"URL":"https:\/\/doi.org\/10.1177\/30502225251414623","relation":{},"ISSN":["3050-2225","3050-2225"],"issn-type":[{"value":"3050-2225","type":"print"},{"value":"3050-2225","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"article-number":"30502225251414623"}}