Trends and factors associated with neonatal mortality among Neonates hospitalized at the Women and Newborn Hospital in Lusaka Zambia in the pre-covid 19 period (preprint)

ABSTRACT

BackgroundNeonatal mortality is a global problem especially in resource-poor settings such as sub-Saharan African Countries. Trends and factors associated with neonatal mortality vary in different settings. This cross-sectional study investigated trends and factors that are associated with increased neonatal mortality among hospitalised neonates with a view of identifying pointers that can be modified to help improve neonatal survival. MethodsMedical records for all neonates admitted to the NICU in 2018 and 2019 were reviewed for the study. The Mortality rates were calculated using WHO standard and Microsoft excel 2010 used to construct monthly trends analysis using monthly totals. Univariate and multivariate logistic regression analysis to determine the factors associated with neonatal deaths at the tertiary facility using Stata version 14.2. Model fit was evaluated using Hosmer and Lemeshow test (chi2=13.90, P =0.0845), implies the models estimates fit the data at an acceptable level. ResultsA total of 7,581 admissions were seen and 2340 files were extracted for analysis, of which 940 (40.2%) died. The overall Neonatal mortality percentage during the study period was 31.8%. Relatively similar trends were observed during the study period with differences in case fatality rates. Factors associated with an increased odds of dying were not attending antenatal care (AOR=2.09, 95% CI [1.46 - 2.99] p <0.0001), parity (AOR=1.09, 95% CI [1.02 - 1.16] p=0.0013) and age of the neonate in days (AOR=0.92, 95% CI [0.91- 0.94] p <0.0001). ConclusionNeonatal mortality is high among hospitalized neonates at the Women and New-born Hospital in Zambia. Associated Factors included no antenatal attendance, increased parity, and early age of the neonate. This has detrimental effects; hence emphasis is on early Antenatal Care for easy monitoring of mother and neonates for fast actions in case of complications