Factors associated with neonatal deaths among neonates admitted to the David Bernardino Pediatric Hospital, 2017-2018, Luanda, Angola

  • Maternal and child health
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In 2016, WHO estimated that 2.6 million deaths, or roughly 46% of all under-five deaths, occurred during the neona- tal period. UNICEF estimates that 29 neonates die in every 1,000 live births in Angola. We aimed to evaluate the risk factors for neonatal deaths at a tertiary and reference Pediatrics Hospital - David Berbardino Pediatric Hospital (DBPH) - in Luanda, Angola.
A 1:2 case-control study was conducted between July 2017 and July 2018, among 587 newborns (196 cases – neonatal deaths and 391 controls – neonatal survivals) who were admitted at DBPH. Semi-structured questionnaires were used for primary data, whereas secondary data was obtained through the review of clinical files. Significance level was set at p<0.05 for all hypothesis tests. Contingency tables with Pearson chi-squared (χ2) tests and pairwise cor- relationswereusedtoidentifyfactorsassociatedwithneonataldeaths. Multivariablelogisticregressionmodeling was used to identify independent factors associated with neonatal deaths and respective adjusted OR.
The risk factors for neonatal death were: interval between the present and previous child less than 2 years (OR = 5.2, 95% CI 3.2 - 8.5, p <0.001), mother’s alcoholism (OR = 3.9, 95% CI 12.4 - 6.5, p <0.001); having less than 4 prenatal consultations (OR = 2.4, 95% CI 1.6-3.6, p = 0.001); very preterm baby - born prior to 32 weeks gestation - (OR = 6.9, 95% CI 4.3-11.3, p <0.001); baby born with gastroschisis (OR = 18.9, 95% CI 7.6-46.7, p <0.001), and baby born with esophageal atresia (OR = 17.9, 95% CI, 4,6-68.9, p <0.001).
As described in other studies, birth defects and very preterm newborns showed the strongest association with neonatal mortality. One limitation of our study was that it was performed at a tertiary hospital and it would be interesting to validate our Results: in other settings of care in Angola. However, there is a need to strengthen and invest in care in Angola, particularly around the time of birth and the first week of life. Further, DBPH needs to ensure that all newborns have access to WHO recommended essential newborn care, especially preterm babies.

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