Neonatal mortality and risk factors in the University Hospital of the Mother and Child Lagoon in Cotonou, Benin, 2015-2016

Abstract

Introduction: The neonatal period is one of the most vulnerable periods for a child’s survival because of the various attacks and infections, majority of which are avoidable mainly through preventive measures. We assessed neonatal hospital mortality and associated factors in a specialized hospital neonatal center. Methods: We conducted a retrospective descriptive study and then a case-control study from January 1, 2015 to December 31, 2016 at the Mother and child University Hospital in Cotonou, Benin. We considered all children hospitalized for any condition in the neonatal unit from January 1, 2015 to December 31, 2016 to conduct the descriptive study. From this population, we selected cases and controls for the case-control study. A case was defined as any newborn hospitalized for any condition in the University Hospital of the Mother and Child Lagoon (CHU MEL) neonatal unit, and who died before the 28th day of life and control was defined as any newborn hospitalized for any affection in the neonatal unit of CHU MEL and discharged alive during the period from January 1, 2015 to December 31, 2016. Socio-demographic, clinical and hospital-related data were recorded. We calculated the proportion and ratio. We conducted univariate, stratified, and logistic regression analysis and calculated odds ratio (ORs), adjusted odds ratios (aOR) and 95% confidence interval to identify risk factors associated with neonatal mortality. Results: We included 2,235 infants in the descriptive study and 828 for the case-control study. The sex ratio Male to female (HF) was 1.2. Mortality was 19% CI (17.08% -20.35%). The main diseases were neonatal jaundice at 33%, neonatal infections (NNI) (30%), prematurity (25%), perinatal asphyxia and other respiratory distress (19%).The risk factors for neonatal death were neonatal infections (aOR = 1.76 95% CI [1.09-2.85], p = 0.020), vaginal delivery (aOR = 1.68 95% CI [1.04-2.71] p = 0.031), preterm birth (aOR = 2.51 95% CI [1.28-3.60], p = 0.003), perinatal asphyxia (aOR = 2.78 95% CI [1.62-4.79] p = 0.0012), low birth weight (aOR = 9.35 95% CI [5.19-16.83] p <0.01), other health center origin (aOR = 1.80 95% CI [1.10-2.94] p = 0.018), resuscitation (aOR = 2.15 95% CI [1.34-3.45] p = 0.001) and malformation (aOR = 28.86 95% CI [7.92-105.15] p < 0.01). Conclusion: Neonatal mortality is high at CHU MEL. In the neonatal period, 80% of deaths occurred. Improvement in the follow-up of newborns, especially those exposed to its factors, will reduce this mortality. The health workers should consider these factors in care management of newborns.