International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 11, No. 3, March 2021 | pp. 17–24

DOI: 10.46882/2021/IJMMS/110017

Original Research Article

A Retrospective Trend Analysis of Neonatal Mortality and Proximate Clinical Determinants in a Regional Referral Hospital

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Neonatal mortality rates remain high in sub-Saharan Africa, serving as a key indicator of regional health equity and medical care quality. This retrospective clinical study analyzed the five-year trend (2015–2019) and proximate clinical causes of neonatal mortality at a regional referral hospital. De-identified clinical data of all neonates who died within 28 days of life were extracted. Out of 11,500 live births recorded over the study duration, 322 neonatal deaths occurred, resulting in an institutional neonatal mortality rate (NMR) of 28.0 per 1,000 live births. Early neonatal deaths (within the first 7 days of life) accounted for 76.4% (246/322) of the cases. The primary direct clinical causes of death were prematurity and related low birth weight complications (34.2%), birth asphyxia/hypoxic-ischemic encephalopathy (29.8%), and severe neonatal sepsis (21.1%). Congenital anomalies accounted for 6.8% of the deaths. Maternal factors significantly associated with increased neonatal mortality risk included a lack of antenatal care attendance (OR = 3.6, 95% CI = 2.1–6.2, p < 0.01), maternal hypertensive disorders of pregnancy (OR = 2.4, p < 0.05), and prolonged obstructed labor (OR = 2.9, p < 0.01). Neonatal mortality remains elevated, driven primarily by preventable or manageable intrapartum and postpartum clinical conditions. Strengthening maternal care quality during the intrapartum window, establishing specialized neonatal care units, and training healthcare staff in neonatal resuscitation are essential actions.

Keywords: Neonatal Mortality, Birth Asphyxia, Prematurity, Neonatal Sepsis, Antenatal Care, Intrapartum Care

Manuscript Timeline: Received: November 11, 2020; Revised: December 19, 2020; Accepted: January 12, 2021; Published: March 10, 2021.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Trend Analysis of Neonatal Mortality and Proximate Clinical Determinants in a Regional Referral Hospital. International Journal of Medicine and Medical Sciences, 2021, 11(3): 17–24. DOI: 10.46882/2021/IJMMS/110017

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