{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:37:40Z","timestamp":1780414660250,"version":"3.54.1"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neonatal mortality is still a major public health problem in middle- and low-income countries like Ethiopia. Despite strategies and efforts made to reduce neonatal death, the mortality rate declines at a slower pace in the country. Though there are studies conducted on neonatal mortality and its determinants, our searches of the literature have found no study on the extent of mortality of neonates born to mothers of extreme reproductive age in the study area. Therefore, this study aimed to assess the magnitude and factors associated with the mortality of neonates born to mothers of extreme reproductive age in Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary data analysis was conducted using 2016 Ethiopian Demographic and Health Survey data. The final study contained an overall weighted sample of 2,269 live births. To determine the significant factors in newborn deaths, a multilevel binary logistic regression was fitted. For measuring the clustering impact, the intra-cluster correlation coefficient, median odds ratio, proportional change in variance, and deviation were employed for model comparison. The adjusted odds ratio with a 95% confidence interval was presented in the multivariable multilevel logistic regression analysis to identify statistically significant factors in neonatal mortality. A <jats:italic>P<\/jats:italic>-value of less than 0.05 was declared statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The neonatal mortality rate of babies born to extreme aged reproductive women in Ethiopia was 34 (95% Cl, 22.2%\u201342.23%) per 1,000 live birth. Being twin pregnancy (AOR\u2009=\u200910; 95% Cl: 8.61\u201320.21), being from pastoralist region (AOR\u2009=\u20093.9; 95% Cl: 1.71\u20138.09), having larger baby size (AOR\u2009=\u20092.93; 95% Cl: 1.4\u20139.12) increase the odds of neonatal mortality. On the other hand, individual level media exposure (AOR\u2009=\u20090.3; 95% Cl: 0.09\u20130.91) and community level media exposure (AOR\u2009=\u20090.24; 95% Cl: 0.07\u20130.83), being term gestation (AOR\u2009=\u20090.14; 95% Cl: 0.01\u20130.81) decreases the odds of neonatal mortality born to mothers of extreme reproductive age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ethiopia had a greater rate of neonatal death among babies born at the extremes of reproductive age than overall reproductive life. Multiple pregnancies, larger baby sizes, emerging regions, term gestation, and media exposure were found to be significant factors associated with the mortality of neonates born to mothers of extreme reproductive age. Therefore, the concerned bodies should give emphasis to mothers giving birth before the age of 20 and above 35, access to media, healthy pregnancy, and special attention to pastoralists to reduce the burden of neonatal mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1390952","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T13:26:25Z","timestamp":1719581185000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mortality of neonates born to mothers of extreme reproductive age in Ethiopia; multilevel mixed effect analysis of Ethiopian demographic and health survey data of 2016"],"prefix":"10.3389","volume":"12","author":[{"given":"Berhan","family":"Tekeba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masresha Asmare","family":"Techane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belayneh Shetie","family":"Workneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alebachew Ferede","family":"Zegeye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almaz Tefera","family":"Gonete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tewodros Getaneh","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulugeta","family":"Wassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemneh Tadesse","family":"Kassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Seid","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enyew Getaneh","family":"Mekonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadesse Tarik","family":"Tamir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.rpped.2014.05.002","article-title":"Extremes of maternal age and child mortality: analysis between 2000 and 2009","volume":"32","author":"Ribeiro","year":"2014","journal-title":"Rev Paul Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e155","DOI":"10.1016\/S2214-109X(13)70179-7","article-title":"Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries","volume":"2","author":"Nove","year":"2014","journal-title":"Lancet Glob Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e007681","DOI":"10.1136\/bmjgh-2021-007681","article-title":"The effect of adolescent pregnancy on child mortality in 46 low-and middle-income countries","volume":"7","author":"Noori","year":"2022","journal-title":"BMJ Global Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/1471-0528.12659","article-title":"Advanced maternal age and pregnancy outcomes: a multicountry assessment","volume":"121","author":"Laopaiboon","year":"2014","journal-title":"BJOG"},{"key":"B5","first-page":"10017","article-title":"United nations children\u2019s fund","volume-title":"The State of the World\u2019s Children","year":"2006"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.4054\/DemRes.2020.43.43","article-title":"Child mortality levels and trends","volume":"43","author":"Ezbakhe","year":"2020","journal-title":"Demogr Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e195","DOI":"10.1016\/S2214-109X(21)00515-5","article-title":"Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN inter-agency group for child mortality estimation","volume":"10","author":"Sharrow","year":"2022","journal-title":"Lancet Glob Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-13-483","article-title":"Neonatal mortality in Ethiopia: trends and determinants","volume":"13","author":"Mekonnen","year":"2013","journal-title":"BMC public Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S0140-6736(14)60497-9","article-title":"Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990\u20132013: a systematic analysis for the global burden of disease study 2013","volume":"384","author":"Wang","year":"2014","journal-title":"Lancet"},{"key":"B10","first-page":"1","author":"Csa","year":"2016"},{"key":"B11","author":"Negera","year":"2013"},{"key":"B12","year":"2012"},{"key":"B13","volume-title":"Progress in Developing an Infant and a Child Feeding index: An Example Using the Ethiopia Demographic and Health Survey 2000","author":"Arimond","year":"2002"},{"key":"B14","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/S0140-6736(05)71048-5","article-title":"4 Million neonatal deaths: when? where? why?","volume":"365","author":"Lawn","year":"2005","journal-title":"Lancet"},{"key":"B15","doi-asserted-by":"publisher","first-page":"287","DOI":"10.21106\/ijma.508","article-title":"Determinants of neonatal mortality in Kenya: evidence from the Kenya demographic and health survey 2014","volume":"10","author":"Imbo","year":"2021","journal-title":"Int J MCH AIDS"},{"key":"B16","volume-title":"Progress on Children\u2019s Well-Being: Centring Child Rights in the 2030 Agenda","year":"2023"},{"key":"B17","doi-asserted-by":"publisher","first-page":"472","DOI":"10.4314\/ejhs.v32i3.1","article-title":"Is neonatal mortality rate in Ethiopia going from bad to worse?","volume":"32","author":"Haileamlak","year":"2022","journal-title":"Ethiop J Health Sci"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5935\/1676-4285.20102872","article-title":"Pregnancy in adolescence: from planning to the desire to become pregnant-descriptive study","volume":"9","author":"de Oliveira Caminha","year":"2010","journal-title":"Online Braz J Nurs"},{"key":"B19","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1093\/ije\/dyy194","article-title":"A prediction model for neonatal mortality in low-and middle-income countries: an analysis of data from population surveillance sites in India, Nepal and Bangladesh","volume":"48","author":"Houweling","year":"2019","journal-title":"Int J Epidemiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1016\/j.jogc.2017.10.027","article-title":"The effect of very advanced maternal age on maternal and neonatal outcomes: a systematic review","volume":"40","author":"Leader","year":"2018","journal-title":"J Obstet Gynaecol Can"},{"key":"B21","doi-asserted-by":"publisher","first-page":"157","DOI":"10.11622\/smedj.2014194","article-title":"Adverse effects of young maternal age on neonatal outcomes","volume":"56","author":"Kang","year":"2015","journal-title":"Singapore Med J"},{"key":"B22","volume-title":"Neonatal Mortality Rate (0 to 27 days) Per 1000 Live Births) (SDG 3.2.2)","author":"Bitew","year":"2023"},{"key":"B23","volume-title":"Spatio-Temporal Inequalities and Predictive Models for Determinants of Undernutrition among Women and Children in Ethiopia","author":"Bitew","year":"2020"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/1415247","article-title":"The magnitude of optimal antenatal care utilization and its associated factors among pregnant women in South Gondar zone, Northwest Ethiopia: a cross-sectional study","volume":"2022","author":"Belay","year":"2022","journal-title":"Int J Reprod Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13104-018-4038-6","article-title":"Determinants of preterm birth among mothers delivered in central zone hospitals, Tigray, Northern Ethiopia","volume":"12","author":"Berhe","year":"2019","journal-title":"BMC Res Notes"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0203098","DOI":"10.1371\/journal.pone.0203098","article-title":"Factors affecting feeding 6\u201323 months age children according to minimum acceptable diet in Ethiopia: a multilevel analysis of the Ethiopian demographic health survey","volume":"14","author":"Tassew","year":"2019","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-015-2639-8","article-title":"Overweight and obesity among women: analysis of demographic and health survey data from 32 Sub-Saharan African countries","volume":"16","author":"Neupane S","year":"2015","journal-title":"BMC public Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.siny.2017.02.006","article-title":"Early neonatal death: a challenge worldwide","volume":"15","author":"Lehtonen","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12887-015-0349-0","article-title":"Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics","volume":"15","author":"Akinyemi","year":"2015","journal-title":"BMC Pediatr"},{"key":"B30","first-page":"42","article-title":"Neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit","volume":"116","author":"Reyes","year":"2018","journal-title":"Arch Argent Pediatr"},{"key":"B31","volume-title":"Ethiopia Mini Demographic and Health Survey 2019: Key Indicators","author":"Ephi","year":"2019"},{"key":"B32","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1001\/archpedi.162.9.828","article-title":"Young maternal age and the risk of neonatal mortality in rural Nepal","volume":"162","author":"Sharma","year":"2008","journal-title":"Arch Pediatr Adolesc Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"NP1106","DOI":"10.1177\/1010539511428949","article-title":"What is the association between maternal age and neonatal mortality? An analysis of the 2007 Bangladesh demographic and health survey","volume":"27","author":"Kamal","year":"2015","journal-title":"Asia Pac J Public Health"},{"key":"B34","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.ajog.2004.10.593","article-title":"Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study","volume":"192","author":"Conde-Agudelo","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1177\/1010539509350758","article-title":"Determinants of infant and child mortality in Periurban areas of Kolkata city, India","volume":"22","author":"Ghosh","year":"2010","journal-title":"Asia Pac J Public Health"},{"key":"B36","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/jech.2009.097170","article-title":"Advanced maternal age and the risk of perinatal death due to intrapartum anoxia at term","volume":"65","author":"Smith","year":"2011","journal-title":"J Epidemiol Community Health"},{"key":"B37","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1111\/j.1479-828X.2012.01442.x","article-title":"Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998\u20132008","volume":"52","author":"Ludford","year":"2012","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-13-1","article-title":"The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis","volume":"13","author":"Kozuki","year":"2013","journal-title":"BMC public Health"},{"key":"B39","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1097\/01.AOG.0000158118.75532.51","article-title":"Impact of maternal age on obstetric outcome","volume":"105","author":"Cleary-Goldman","year":"2005","journal-title":"Obstet Gynecol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e0202318","DOI":"10.1371\/journal.pone.0202318","article-title":"Multiple birth rates of Korea and fetal\/neonatal\/infant mortality in multiple gestation","volume":"13","author":"Ko","year":"2018","journal-title":"PLoS One"},{"key":"B41","doi-asserted-by":"publisher","first-page":"084","DOI":"10.1055\/s-0035-1559807","article-title":"Improved perinatal mortality in twins\u2014changing practice and technologies","volume":"2","author":"Hehir","year":"2016","journal-title":"Am J Perinatol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.bpobgyn.2018.02.004","article-title":"Fetal growth restriction in twins","volume":"49","author":"Townsend","year":"2018","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2393-14-165","article-title":"Individual and community determinants of neonatal mortality in Ghana: a multilevel analysis","volume":"14","author":"Kayode","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e1001292","DOI":"10.1371\/journal.pmed.1001292","article-title":"Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis","volume":"9","author":"Marchant","year":"2012","journal-title":"PLoS Med"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1097\/AOG.0b013e3182179e28","article-title":"Term pregnancy: a period of heterogeneous risk for infant mortality","volume":"117","author":"Reddy","year":"2011","journal-title":"Obstet Gynecol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"S202","DOI":"10.1016\/j.ajog.2006.10.725","article-title":"\u201cEarly\u201d term births (37\u201338 weeks) are associated with increased mortality","volume":"195","author":"Reddy","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1001\/jamapediatrics.2013.2581","article-title":"Adverse neonatal outcomes associated with early-term birth","volume":"167","author":"Sengupta","year":"2013","journal-title":"JAMA Pediatr"},{"key":"B48","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/01.AOG.0000297311.33046.73","article-title":"Neonatal mortality and morbidity rates in late preterm births compared with births at term","volume":"111","author":"McIntire","year":"2008","journal-title":"Obstet Gynecol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3329\/jasbs.v44i1.46541","article-title":"Neonatal, infant and under-five mortality: an application of cox proportional hazard model to BDHS data","volume":"44","author":"Nilima","year":"2018","journal-title":"J Asiat Soc Bangladesh Sci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1475-9276-10-1","article-title":"Determinants of institutional delivery in rural Jhang, Pakistan","volume":"10","author":"Agha","year":"2011","journal-title":"Int J Equity Health"},{"key":"B51","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1002\/uog.20279","article-title":"Maternal and neonatal complications of fetal macrosomia: systematic review and meta-analysis","volume":"54","author":"Beta","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"00089","DOI":"10.15406\/jpnc.2015.02.00089","article-title":"Determinants of early neonatal mortality in Nigeria: results from 2013 Nigeria DHS","volume":"2","author":"Dahiru","year":"2015","journal-title":"J Pediatr Neonatal Care"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-020-03485-8","article-title":"Individual-and community-level determinants of neonatal mortality in the emerging regions of Ethiopia: a multilevel mixed-effect analysis","volume":"21","author":"Tesema","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"B54","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/978-94-007-7061-4_17","article-title":"Rural poverty and marginalization in Ethiopia: a review of development interventions","author":"Admassie","year":"2014","journal-title":"Marginality"},{"key":"B55","volume-title":"Provision of and Participation in Primary Education in the Pastoralist Regions of Afar and Somali of Ethiopia","author":"Woldesenbet","year":"2015"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1390952\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T13:26:37Z","timestamp":1719581197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1390952\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,28]]},"references-count":55,"alternative-id":["10.3389\/fped.2024.1390952"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1390952","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,28]]},"article-number":"1390952"}}