Determinants of neonatal mortality at Wesley Guild Hospital, Ilesa, Nigeria.

BACKGROUND: More than 10 million under five children die each year of preventable and easily treatable conditions in developing countries. Of these, eight million are infants, half of whom are newborns in their first month of life. A high proportion of babies die in their first month of life, many of them during their first week. The objective of this study is to assess sociodemographic and other determinants of neonatal mortality in Wesley Guild Hospital (WGH), Ilesa, Nigeria.

METHODS: This is a record review of 235 neonatal deaths reported at WGH from January 01 2001 to December 31 2003. Similarly, records of equal number of neonates (235) admitted to the same hospital during the same period but who were discharged alive was also reviewed for comparison. Four hundred and seventy records were reviewed. The two groups were matched for age, sex and within a 7-day period of admission. Information was collected with the aid of predesigned schedule from the patients' case notes, death registers and discharge summaries in the Records Department of the hospital. Information collected included the bio-data of the mothers, birth weight of neonates, estimated gestational age at delivery, age at death or discharge, date of admission, duration of the illness and date of discharge. Others included mode and place of delivery, maternal booking status and complications of pregnancy and birth. Data were analyzed using descriptive and inferential statistics by computer software, Epi-Info 2002.

RESULTS: Teenage pregnancy, low birth weights (LBW), prematurity and neonatal tetanus were positively associated with neonatal death. Unbooked mothers, deliveries at missions and homes and low socioeconomic status were also positively associated with neonatal death (P < 0.05 in all cases). There was no statistically significant association between the sex of neonate, parity of mother and complications in pregnancy with neonatal death (P > 0.05 in all cases).

CONCLUSION: The major determinants of neonatal deaths were teenage pregnancy, prematurity, LBW, poverty and lack of skilled attendance at delivery. Addressing the basic determinants of neonatal mortality will improve newborn survival and health and this will significantly reduce mortality among under five children in developing countries.