Peer-reviewed article
Preventable maternal and neonatal factors of early and late neonatal mortality in rural city of Tshumbe, Sankuru Province, Democratic Republic of the Congo.
Etongola Papy Steve Mbelambela, Okitambolo Marie Catherine Mbutshu, Antonio Fredelindo Villanueva, Okitale Daniel Tokoko, Musembula Hilaire Kelakela et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined preventable causes of neonatal death in rural Democratic Republic of the Congo between 2022 and 2024, reviewing 246 deaths among 1,827 births. Maternal malaria and urogenital infections were the strongest risk factors, accounting for most deaths. Lack of prenatal care, low birth weight, and premature birth significantly increased early neonatal mortality risk, while maternal tetanus vaccination reduced this risk.
Key points
- Malaria in pregnancy was associated with neonatal mortality in 85.77% of deaths (aOR: 4.12)
- Urogenital infection in mothers accounted for 72.36% of neonatal deaths
- Zero prenatal visits increased early neonatal mortality risk nearly 3.6 times (aOR: 3.57)
- Low birth weight and very premature birth were significant risk factors (aOR: 2.00 and 2.13 respectively)
- Maternal tetanus vaccination history reduced early neonatal mortality risk
Limitations
This is a retrospective observational study from one rural setting, so findings may not generalize to other regions or settings with different malaria transmission patterns or healthcare systems. The study cannot determine causality or explain mechanisms underlying the observed associations.
Abstract
BACKGROUND: The first 28 days of life, known as the neonatal period, is most vulnerable time for child's survival. Prematurity, infections, and respiratory distress are the most important causes of neonatal death. AIM: This study aimed to evaluate preventable maternal and neonatal factors of early and late neonatal mortality in Rural city of Tshumbe, Sankuru Province, Democratic Republic of the Congo. METHODS: This retrospective observational study was conducted between January 1, 2022 to December 31, 2024, in three health centres. Maternity ward recorded 1827 births, of which 369 neonates were admitted to pediatrics, and 246 neonate deaths within the first 28 days were documented. Multivariate analysis was performed to evaluate the association between maternal and neonatal factors on neonatal mortality. RESULTS: Malaria in pregnancy and urogenital infection accounted for 85.77%, and 72.36% of neonatal deaths, respectively (p = 0.001) (p < 0.05). Association between paludism in pregnancy (aOR: 4.12, 95% CI: 1.71;9.89), hypotrophic birth weight, (aOR: 2.00, 95% CI: 1.02;3.91), very premature (aOR: 2.13; 95% CI: 1.04;4.37), zero prenatal visit (aOR: 3.57, 95% CI: 1.30; 9.77) and early neonatal mortality were found. Additionally, the risk of early neonatal mortality decreased for women with a history of two to three vaccination (aOR: 0.18, 95%CI:1.62; 6.26). CONCLUSION: Significantly higher rates of early mortality were revealed among respondents with no prenatal visits. Furthermore, malaria in pregnancy, low birth weight and very preterm birth were associated with early neonatal mortality. In addition, the risk of early neonatal mortality decreased with increasing tetanus vaccination coverage among women.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Not applicable - this is an observational study of risk factors, not an intervention evaluation
- Population
- 1,827 births documented in maternity wards; 246 neonatal deaths within first 28 days
Key finding
Maternal malaria in pregnancy: aOR 4.12 (95% CI: 1.71-9.89) for early neonatal mortality