Po 8592 why, When and Where Do Newborns Not Only Get Sick but Also Die in São Tomé and Príncipe? A Case-Control Study

Abstract

BackgroundNeonatal deaths in São Tomé and Príncipe account for about 43% of all under-5 deaths, but there are major gaps in understanding this. The objective of this study was to identify ante-, intra-, and post-partum risk factors and to analyse characteristics of neonatal morbimortality.MethodsStillbirths and sick newborns (NB) with ≥32 week´s gestation or ≥1500 g were eligible cases, while controls were healthy newborns≥28 days. The study is still underway, and more data will become available. Results presented here are from a questionnaire applied by the investigator, and from medical records of mothers and newborns. Point-of-care tests were used to screen for syphilis, HIV and Hepatitis B. The SPSS 23 statistical programme was used for data analysis. Informed consent was obtained from every mother included in the study.ResultsOut of 675 mothers, 132 were enrolled corresponding to 134 newborns (2 twins), while 35 cases and 41 newborn controles were followed up. Pregnant women’s medium age was 26 years, 23% being adolescents and 23% without antenatal care. Primary education was attended by 57%, secondary by 63%, 7% never attended school. Syphilis – 1/96 reactive test; HIV or malaria not detected; 3 infected with HBV. Newborn morbimortality: 10 preterm, 12 birth asphyxia, 30 with risk of neonatal and 8 with invasive infections, 8 foetal growth restriction, 5 microcephaly, 4 minor congenital anomalies and 1 death in the first 24 hours of life (congenital lung anomaly). Low birth weight (<2500 g), meconium and caesarean section were statistically significant with respect to „morbidity (p<0.05). No deaths were verified in the 76 babies followed up.ConclusionIn this study, newborn morbidity was high (59%). More conclusions will be drawn when a higher number of participants is included and analysed. As a result, at the completion of this study, we hope to be able to design an intervention algorithm in order to achieve peri-neonatal morbimortality reduction.

Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study

“…To the best of our knowledge, this is the first study to assess perinatal and neonatal deaths in STP, and it was undertaken within the context of a broader project on neonatal adverse birth outcomes (ABOs) and other maternal problems in this LMIC (25)(26)(27)(28)(29)(30)(31).…”

Intestinal parasitic infections and adverse outcomes for pregnant women and their newborns in Sao Tome &amp; Principe: a hospital-based cross-sectional study

“…Additionally, the country has a high rate of ABOs and perinatal and neonatal mortality rates and, since 2016, the authors have been conducting a broader project on maternal and neonatal health, studying the causes and factors associated with peri-neonatal mortality and ABOs in STP [39][40][41][42][43].…”

Factors associated with peri-neonatal mortality in Sao Tome & Principe: a prospective cohort study

“…To the best of our knowledge, this is the first study to assess peri-neonatal mortality in STP, and it was undertaken within the context of a broader project on neonatal adverse birth outcomes (ABOs) in this LMIC [23][24][25].…”