Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit

Abstract

Introduction. The increasing survival rate of preterm infants has altered the epidemiology of neonatal diseases; however, neonatal mortality is still the main component of child mortality. The objective of this study was to evaluate neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit. Material and methods. Prospective cohort study conducted between January 2016 and January 2017 at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca." The incidence of deaths and associated conditions was evaluated using a multivariate logistic regression analysis. Results. A total of 9366 live births were registered; 15% (n: 1410) of these were admitted to the neonatal care unit. The mortality rate was 125.5 per 1000 hospitalized newborn infants (95% confidence interval [CI]: 109 144); the main reasons for admission were congenital malformations or genetic disorders (28.2%), infections (24.9%), and respiratory distress (20.9%). The conditions associated with death were gestational age < 37 weeks (OR: 2.41, 95% CI: 1.493.93), birth weight ≤ 1500 grams (OR: 6.30, 95% CI: 4.15 9.55), moderate/severe respiratory distress at 10 minutes (OR: 1.89, 95% CI: 1.242.86), Apgar score < 7 at 5 minutes (OR: 9.40, 95% CI: 5.76 15.31), congenital malformations (OR: 5.52, 95% CI: 3.12 9.78), and less than 5 antenatal care visits (OR: 1.51, 95% CI: 1.09 2.08). Conclusions. Preterm birth, low birth weight, respiratory distress, Apgar score < 7, congenital malformations, and a history of < 5 antenatal care visits were associated with a higher risk for death.