Timing and causes of neonatal mortality in Tamale Teaching Hospital, Ghana: A retrospective study

Abstract

Neonatal deaths now account for more than two-thirds of all deaths in the first year of life and for about half of all deaths in children under-five years. Sub-Saharan Africa accounts up to 41% of the total burden of neonatal deaths worldwide. Our study aims to describe causes of neonatal mortality and to evaluate predictors of timing of neonatal death at Tamale Teaching Hospital (TTH), Ghana. This retrospective study was conducted at TTH located in Northern Ghana. All neonates who died in the Neonatal Intensive Care Unit (NICU) from 2013 to 2017 were included and data was obtained from admission and discharge books and mortality records. Bivariate and multivariate logistic regression were used to assess predictors of timing of neonatal death. Out of the 8,377 neonates that were admitted at the NICU during the 5-year study period, 1,126 died, representing a mortality rate of 13.4%. Of those that died, 74.3% died within 6 days. There was an overall downward trend in neonatal mortality over the course of the 5-year study period (18.2% in 2013; 14.3% in 2017). Preterm birth complications (49.6%) and birth asphyxia (21.7%) were the top causes of mortality. Predictors of early death included being born within TTH, birth weight, and having a diagnosis of preterm birth complication or birth asphyxia. Our retrospective study found that almost 3/4 of neonatal deaths were within the first week and these deaths were more likely to be associated with preterm birth complications or birth asphyxia. Most of the deaths occurred in babies born within health facilities, presenting an opportunity to reduce our mortality by improving on quality of care provided during the perinatal period.

Association of maternal obesity with fetal and neonatal death: Evidence from South and South-East Asian countries

“…Baroni et al [ 7 ] investigated the neonatal mortality rates in Brazil, whereas Liu et al [ 8 ] and Abdul-Mumin et al [ 9 ] investigated the key reasons for neonatal death and preterm birth in China and Ghana. Regional investigations have identified that preterm birth, intrapartum complications and pneumonia (in case of China), and preterm birth complications and birth asphyxia (in case of Ghana) are the leading causes of neonatal deaths [ 8 , 9 ]. On a global scale, the major causes of neonatal death include preterm birth, severe infections and asphyxia [ 10 ].…”

“…Previous researchers have mostly considered a single outcome variable; in some cases, two variables were considered to examine the association between maternal obesity with other variables of interest, including miscarriage, stillbirth [ 4 ] and neonatal death [ 8 , 9 ]. In contrast, this research has taken a holistic approach to compare and contrast how maternal obesity is related to pre and post-birth maternal and neonatal risk factors by including multiple outcome variables together.…”

Clinical features of bacterial meningitis among hospitalised children in Kenya

“…These changes may be attributed to conjugate vaccination and herd immunity in older children. Our study excluded infants aged <60 days who typically have bacterial meningitis due to different pathogens [17], different clinical presentation [26], and alternative diagnoses such as birth asphyxia [27], and associated higher risk of neurological disability and mortality [17].…”

Examining the Causes of Neonatal Mortalities in the Tamale Metropolis

“…For example, neonatal deaths reduced from 30 per 1000 live births in 1998 to 25 per 1000 live births in 2017 [6]. There was a descending trend in neonatal mortality over 5year period between 2013 to 2017 [7].…”

“…Determinants of neonatal deaths in Ghana include multiple births, household size, parity, contraceptives use, birth weight, and population density [6]. The predictors of early neonatal death for Normal Birth Weight Babies in Tamale Metropolis include gender, being born at Tamale Teaching Hospital and Birth Asphyxia while Low Birth Weight are the place of delivery and Birth Asphyxia [7]. Siakwa et al [4] stated the global three top causes of neonatal deaths as birth asphyxia (41%) infection (29%), preterm (29%) and prematurity and Low Birth Weight (15%).…”