Common Causes and Risk Factors for Neonatal Death in NICU in Tobruk Medical Center between July 2018 and July 2019, Libya

Abstract Background  Of the 130 million babies born worldwide each year, an estimated 4 million die during the neonatal period. Of the total global neonatal mortality, 99% occurs in low- and middle-income countries, particularly in Africa and South Asia. The current study was designed to calculate the neonatal mortality rate (NMR), analyze the causes of neonatal deaths, and examine risk factors contributing to neonatal deaths in the neonatal unit of Tobruk Medical Center (TMC). Methods  A case-control study was conducted on 180 newborns divided into two groups admitted to the neonatal intensive care unit (NICU) on the same day of delivery. The first group included 90 newborns who died before day 28 and the second group included 90 newborns who survived until the time of discharge and were selected randomly. The data of the patients were collected from the medical records of newborns admitted to the neonatal unit at TMC between July 2018 and July 2019. All data in this study were statistically analyzed using SPSS 23.0 for Windows (SPSS Inc., Chicago, IL, United States). Results  The NMR among the studied neonates was 12.3 per 1,000 live births, and the death rate was 16.36% per 1,000 admissions. The most common causes of mortality were premature birth (55, 61%), birth asphyxia (18, 20%), and congenital anomalies (10, 11.2%). Less than 50% of the dead patients were on a mechanical ventilator. Premature birth and low birth weight patients are strong predictors of neonatal mortality; normal vaginal delivery had a higher risk of mortality than the other methods of delivery. Gender, maternal blood group, maternal age, and past obstetrical and medical history had no positive correlation with mortality except for antepartum hemorrhage. Conclusions  The study found that the rate of neonatal mortality is similar to that of other hospitals in developing countries and the most common cause of neonatal death was premature birth, and premature birth and low birth weight were the main risk factors for death.