Risk Factors of Early Neonatal Deaths in Pediatric Teaching Hospital in Bangui, Central African Republic

Background: The neonatal mortality rate in the Central African Republic (CAR) is 42.3 per 1000 live births in 2017, indicating that CAR is with the highest number of newborn deaths. Objective: The objective is to clarify the risk factors of neonatal deaths in this area. Methodology: A case-control study with retrospective data collection. Targets were newborns >7 days, hospitalized and dead (cases), and newborns admitted after the respective case during the study period and discharged before the 7th day of life. This study was carried out between 2016 and 2018 in the neonatal unit of the “Complexe Hospitalier Universitaire Pédiatrique de Bangui” (CHUPB), the only national hospital for newborns care in the CAR. Results: We included 902 newborns, with 451 cases of early neonatal death and 451 controls. 4168 newborns were admitted to the neonatology unit with 621 early death cases;a lethality rate of 14.9%. Early neonatal deaths factors were: newborns with low birth weight (OR = 22.59;95% CI [15.93 - 32.04]; P < 0.001);mothers who did not attend antenatal care (OR = 5.54;95% CI [3.95 - 7.79];P < 0.001), home delivery (OR = 0.70;95% CI [0.03 - 0.15];P < 0.001);young maternal age < 25 years (OR = 2.08;95% CI [1.58 - 2.73];P < 0.001);non-medical transport (OR = 2.14;95% CI [1.03 - 4.46];P = 0.03);origin from remote areas (OR = 5.25;95% CI [3.95 - 6.98];P < 0.001);isolated prematurity (P < 0.01);anoxo-ischemic encephalopathy (OR = 12.72;95% CI [6.54 - 34.73];P < 0.01);delivery by cesarean section (OR = 0.59;95% CI [0.41 - 0.84];P < 0.001);preterm delivery (OR = 29.36;95% CI [20.12 - 42.81];P < 0.001), and maternal lower education (OR = 5.65;95% CI [4.08 - 7.81];P < 0.001). Conclusion: The early neonatal mortality rate remains high in this area. Controlling the factors mentioned above might lead to improving the survival of newborns.