Pattern and risk factors of early neonatal morbidity and outcome in Omdurman Maternity Hospital Nursery Unit

Abstract

Neonatal mortality and morbidity remains a major problem in many developing countries, most of its predisposing factors are preventable. The objectives of this study were to determine the incidence of early neonatal outcome in Omdurman Maternity Hospital Nursery Unit, to describe the pattern of early neonatal morbidity and to evaluate the risk factors associated with early neonatal mortality. The study was prospective, case control, hospital-based study, conducted in Omdurman Maternity Hospital in the period from August 2004 till January 2005, where 202 newborns admitted to Omdurman Maternity Hospital Nursery Unit were followed till their 7th day of life and 202 newborns delivered at the nearest time in the hospital was taken as a control. The outcome of the study was 174 newborns were alive (72.8%), while 55 newborns were early neonatal deaths (27.2%) and the incidence of early neonatal mortality in this study was estimated to be 6.6/1000 live births. Causes of early neonatal morbidity were found to be prematurity (39.1%), followed by birth asphyxia (19.3%), neonatal jaundice (12.4%), congenital malformations (11.4%) and neonatal sepsis (6.4%). Prematurity accounted for about half early neonatal mortality (56.4%), other causes of early neonatal mortality were congenital malformations (20.0%), birth asphyxia (4.5%) and neonatal sepsis (3.6%). Risk factors associated with early neonatal mortality in this study were found to be gestational age of less than 37 weeks (RR: 2.8). Another risk factor associated with early neonatal mortality was the birth weight of less than 1.50 kg, which carried five times risk of early neonatal mortality (RR 5.18). Maternal factors such as age, education and number of antenatal care visits and positive history of neonatal deaths carried no relative risk for early neonatal mortality in this study (RR = 0.806, 0.218, 0.74 respectively).