Assessment of Neonatal Mortality amongst Sick Neonates in the Special Care Baby Unit of a Tertiary Institution in Orlu, Nigeria

Abstract

Introduction: Neonatal mortality constitutes more than 41% of under 5 mortality in sub-Saharan Africa, despite advancement in technology and concerted effort aimed at decreasing under-five mortality. This study aims at assessing the risk factors and causes of neonatal mortality among sick infants in the special care baby unit (SCBU); focused at identification of possible areas of improvement in care and result.  Methods: A retrospective review of medical records of sick neonates admitted into SCBU of Imo State University Teaching Hospital Orlu. Sociodemographic and clinical characteristics of 214 sick neonates that died was obtained out of the 948 admitted/treated over a five year period (2018-2022). Descriptive statistics was used to summarize data, logistic regression at 95% level of significance was used to determine association between independent variables and neonatal death. Values of p < 0.05 were considered significant. Results: A total of 948 sick neonates were admitted into SCBU, with a neonatal mortality rate of 22.6%. Complications of prematurity 78 (36.7%), severe birth asphyxia 63(29.6%) and neonatal sepsis 31(14.6%) are the leading causes of death with majority of death occurring in the first 24 hours of life 130(60.8%). Low birth weight [OR=2.59 (95% CI 1.84-3.54)], prematurity [OR=2.79 (95% CI 2.03-3.83)] and spontaneous vaginal deliveries [OR=1.85 (95% CI 1.32-2.60)] were positively associated with increased mortality. While Caesarean section as mode of delivery [OR=0.54 (95% CI 0.38-0.76)] and birth weight >2.5-4.0kg [OR=0.46 (95% CI 0.34-0.64)] significantly reduced neonatal mortality. Conclusion: Neonatal mortality rate is still unacceptably high, with complications of prematurity, severe birth asphyxia and neonatal sepsis contributing the highest percentage of poor outcome (death). Low birth weight, prematurity, and spontaneous vaginal deliveries were positively associated with increased mortality. Multidisciplinary measures aimed at reduction of neonatal morbidity and mortality such as improving the utilization of antenatal care services, quality of care at delivery, at the neonatal intensive care unit needs be strengthened.