A Two-Year Retrospective Hospital-Based Cross-Sectional Review of Neonatal Morbidity and Mortality: Experience from a University Teaching Hospital

Abstract

Background:
Neonatal mortality remains a major public health challenge in Nigeria, with prematurity, birth asphyxia, infections and congenital  anomalies contributing substantially to morbidity and mortality. This study examined patterns of neonatal morbidity and mortality and identified factors associated with neonatal mortality among neonates admitted to the Special Care Baby Unit (SCBU) at Modibbo Adama University Teaching Hospital (MAUTH) in Yola.

Results:
Of the 2,059 neonatal admissions during the study period, 1,960 records contained sufficient information and were included in the analysis. The leading causes of neonatal morbidity and mortality were prematurity, perinatal asphyxia, congenital anomalies, sepsis, and neonatal jaundice. Prematurity accounted for the highest proportion of deaths, while congenital anomalies had the highest case-fatality rate. In multivariable logistic regression analysis, preterm birth

Subjects and Methods:
This retrospective hospital-based study reviewed the records of neonates admitted to the SCBU at MAUTH in Yola from 1 June 2021 to 31 May 2023. Data on demographic characteristics, clinical diagnoses, place of birth, gestational age, maternal factors and outcomes were extracted from case records. Bivariate and multivariable logistic regression analyses were conducted to identify factors independently associated with neonatal mortality. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was set at p<0.05. (aOR=2.27, 95% CI: 1.74-2.97, p<0.001), outborn status (aOR=3.28, 95% CI:2.50-4.30, p <0.001), primiparity (aOR=1.50, 95% CI: 1.07 2.09, p = 0.018) and grand multiparity (aOR=1.47, 95% CI: 1.06-2.03, p=0.020) were independently associated with neonatal mortality.

Conclusion:
Neonatal mortality was independently associated with prematurity, outborn status, and maternal parity. Strengthening referral systems, improving care of the preterm infants, and enhancing maternal and newborn healthcare services may help reduce preventable neonatal deaths.