A cohort analysis of neonatal hospital mortality rate and predictors of neonatal mortality in a sub-urban hospital of Cameroon
Open Access
- 5 June 2017
- journal article
- research article
- Published by Springer Science and Business Media LLC in Italian Journal of Pediatrics
- Vol. 43 (1), 52
- https://doi.org/10.1186/s13052-017-0369-5
Abstract
In Cameroon, sustainable effort needs to be done to reduce the current neonatal mortality rate from 21 deaths per 1000 live births to the global target of fewer than ten deaths per 1000 live births by 2035. We aimed to determine the neonatal hospital mortality rate and predictors of neonatal hospital mortality (NHM) in a major referral sub-urban hospital of Cameroon in a bit to formulate interventions to curb this burden. This was a prospective cohort study consecutively enrolling all neonates admitted into the neonatology unit of the Bamenda Regional Hospital (BRH) from November 2015 to February 2016. Through interviewed questionnaires to parents and physical examination of neonates, we studied socio-demographic characteristics, antenatal history, intrapartum history and clinical findings of neonates. Neonates further underwent relevant laboratory investigations for diagnosis. All neonates were followed up till 28 days after the post-menstrual term for the neonatal outcomes. Multiple logistic regression was used to determine predictors of NHM. We enrolled 332 out of 337 neonates admitted to the neonatology unit of BRH during the study period. Fifty-three percent (53%) were males. Their mean gestational age and birth weight were 36.9 ± 3.9 weeks and 2677.2 ± 923 g, respectively. The main causes of neonatal admissions were complications of preterm birth (32.2%), neonatal infections (31.3%), and birth asphyxia (14.5%). The neonatal hospital mortality rate was 15.7%. NHM was related to complications of preterm birth (69%), birth asphyxia (23%) and neonatal infections (6%). A five-minute Apgar score less than seven was the only predictor of NHM (aOR: 16.41; CI 95%: 6.35–42.47; p < 0.01). Neonatal mortality still remains a significant health problem in sub-urban Cameroon, mainly as a result of three pathologies; complications of preterm birth, birth asphyxia, and infections. There is an urgent need to revamp the current health policies through the improvement of antenatal care, skilled birth attendants, neonatal resuscitation, timely detection and treatment of complications of preterm births, birth asphyxia, and infections.Keywords
This publication has 19 references indexed in Scilit:
- Neonatal respiratory distress in a reference neonatal unit in Cameroon: an analysis of prevalence, predictors, etiologies and outcomesPan African Medical Journal, 2016
- Low birth weight in a sub-urban area of Cameroon: an analysis of the clinical cut-off, incidence, predictors and complicationsBMC Pregnancy and Childbirth, 2015
- Morbidité et facteurs de risque de mortalité néonatale dans un hôpital de référence de DoualaPan African Medical Journal, 2015
- Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysisThe Lancet, 2014
- Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends, associated factors and causes.African Health Sciences, 2014
- Morbidité et mortalité néonatale dans un hôpital de district urbain à ressources limitées à Douala, CamerounArchives de Pédiatrie, 2014
- Mortalité néonatale précoce et ses déterminants dans une maternité de niveau I à Yaoundé, Cameroun2012
- Mortalité néonatale au centre hospitalier régional de Tsévié (Togo)Archives de Pédiatrie, 2006
- Sample Size Estimation: How Many Individuals Should Be Studied?Radiology, 2003
- Perinatal asphyxia: multivariate analysis of risk factors.2000