Risk factors for neonatal mortality at the yaounde gynaeco-obstetric and pediatric hospital, cameroon

ABSTRACT

Neonatal mortality is a major health problem in sub-Saharan Africa and the risk factors are not well established. The objective of this study was to determine the risk factors for neonatal mortality at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. We conducted a retrospective and analytic case-control study from the medical records of newborns admitted at the neonatal unit of this hospital between 1[st] March 2003 and 31[st] December 2012. 850 subjects were enrolled; that is 425 cases and 425 controls. The intra-hospital neonatal mortality rate was 9.83%. The main causes of neonatal mortality were in descending order neonatal sepsis [60.2%], complications from prematurity [42.6%], birth asphyxia [37.4%], and congenital malformations [11.8%].The most prominent risk factors for neonatal mortality after multivariate analysis with logistic regression were prolonged membrane rupture [OR 3.8719, 95% CI 2.3619-6.3471; P=0.0000], low birth weight [OR 1.6240, 95% CI 1.0108-2.6091; P=0.0450], Apgar score less than 7 at the 5th minute [OR 6.8979, 95% CI 4.0709-11.6883; P=0.0000], and congenital malformations [OR 4.3307, 95% CI 1.6120-11.6347; P=0.0037]. Delivery by cesarean section [OR 0.2644, 95% CI 0.1478-0.4732; P=0.0000] and being born in this hospital [OR 0.4409;95% CI 0.2566-0.7576; P=0.0030] were protective. Neonatal mortality was influenced by both maternal and neonatal factors. This could be reduced through sensitization of pregnant women on the need of good quality antenatal visits, and capacitating the health personnel on the adequate management of high risk neonates