Prognostic factors for neonatal mortality at the Agadir regional hospital centre, Morocco: A cohort study

Abstract

Introduction: Although neonatal mortality is declining globally, progress is slow, particularly in Africa. The goal of this study was to determine the predictive factors associated with survival in newborns at the Agadir Regional Hospital Centre, Morocco. Methods: This retrospective cohort study performed at the neonatology department of the Agadir Regional Hospital Centre included neonates, from birth to 28 days old, who were hospitalized between January 1 and May 9, 2022. Prognostic factors were determined through univariate analysis with the Kaplane Meier survival analysis method, and survival rates were compared with the log-rank test. The Cox model was used to determine factors associated with neonatal survival. Results: Of 639 enrolled newborns, 95.9 % were hospitalized during the first week of life. A total of 115 newborns died, resulting in an in-hospital neonatal mortality rate of 18 % (95 % CI [15.2-21.2]), and 98.3 % were early neonatal deaths. The factors associated with elevated death risk were perinatal asphyxia (aHR = 2.61, 95 % CI [1.57-4.43], p < 0.001); prematurity (aHR = 2.15, 95 % CI [1.17-3.94], p = 0.013); neonatal age 7 days (aHR = 4.89, 95 % CI [1.14-20.94], p = 0.032); low birth weight (aHR = 2.25, 95 % CI [1.28 -3.94], p = 0.005); and hypothermia (aHR = 7.60, 95 % CI [1.71-33.73], p = 0.008). Conclusion: The neonatal mortality rate remains high. Developing the skills of healthcare providers, strengthening risk screening for pregnancies, and enhancing resuscitation and early care for newborns are essential to decrease neonatal mortality.