A Retrospective Analysis of Neonatal Mortality
Introduction: Neonatal mortality is a serious health issue, especially indeveloping countries where vast majority of neonatal deaths (NND) occurand accurate data are sparse. This study aimed to determine the major causes of hospital NND in relation to certain maternal and neonatal factors.
Methods: A retrospective analysis of all NND in the neonatal care unit at Al-Sadaqa Teaching Hospital, over one-year period (2017). Data extracted from clinical records include: age, sex, birth weight, gestational age, mode/place of delivery, twin status, parity, maternal age, antenatal care, residency, diagnosis, duration of hospital stay, time and cause of death. The cause of death was based on physician judgment and major causes were classified according to the Global Network Cause of Death
algorithm. Data analysis were executed using SPSS version 20.
Result: Of 1565 sick neonates, 283 were died giving a hospital neonatal mortality of 18.1%. Males outnumbered females (59.0% vs. 41.0%, p=0.002) and majority of patients (77.5%) were admitted during their first 24 hours of life. Neonates born at the hospital maternity (in-born) were 161 (56.9%); the rest were out-born (43.1%). Majority of neonates (92.2%) were singleton, and 7.8% were twins. Vaginal delivery occurred in 82.0% whereas 18.0% were delivered by cesarean section. There were 35.0% primipara and 65.0% multiparous mothers. Early NND occurred in 83.0%, and was significantly higher than late new natal death (p<0.001). Just more than half (59.5%) were preterms and 67.8% were of low birth weight. The primary causes of death were prematurity (52.3%), followed by birth asphyxia/injury (19.4%), neonatal infections (17.3%) and congenital malformations (8.5%).
Conclusion: Neonatal mortality in Al-Sadaqa hospital remains unacceptably high. Prematurity and its complications, birth asphyxia and sepsis were the main causes of death. Early NND comprises a significant proportion of deceased infants. Effective interventions to improve perinatal care are crucial.
Keywords: Neonatal death, Gestational age, Birth weight, Cause of death, Retrospective Survey.