Peer-reviewed article
Incidence, risk factors and outcomes of neonatal near miss in Lagos, Nigeria: a prospective case-control study.
Ashaolu AT, Adeoye IA ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined neonatal near miss (a life-threatening event in newborns aged 0-28 days that the baby survived) in a Lagos hospital. Researchers compared 161 newborns who experienced near-miss events with 321 healthy newborns to identify risk factors. The incidence was high at 198 per 1000 live births. Key risk factors included being referred from another facility, having maternal pregnancy complications, and lack of antenatal care visits, while adequate antenatal care was protective. All babies in the study survived to 28 days, though many remained in intensive care.
Key points
- Incidence of neonatal near miss was 198 per 1000 live births
- Referral from another facility was associated with 4.45 times higher odds of near miss
- Having four or more antenatal care visits reduced odds of near miss by 73%
- Hypertensive disorders of pregnancy increased odds of near miss by 2.71 times
- All surviving newborns in the study remained alive at 28 days, though many were still hospitalized
Limitations
This was a hospital-based study at one facility in Lagos, so findings may not represent all of Nigeria or other settings. The case-control design can identify associations but cannot establish causation, and some protective or risk factors may be confounded by unmeasured variables.
Abstract
Background Neonatal near miss (NNNM) refers to a newborn aged 0-28 days old who had a life-threatening event but survived either by chance or the quality of care received. Studies on neonatal near misses are lacking in Nigeria. This study determined the incidence, risk factors, and outcome of neonatal near misses among Lagos Island Maternity Hospital newborns. METHODS: A hospital-based unmatched case-control study was conducted in Lagos Island Maternity Hospital (161 cases and 321 controls). This study identified and adapted the neonatal near miss from the WHO maternal near miss tools, in which the newborn encountered at least one of the following criteria (pragmatic, management, clinical/laboratory/organ dysfunction marker) but survived the complications. We followed up with the neonates and assessed neonatal outcomes on the 28th day of life. Bivariate and multivariable logistic regression analyses were performed, and OR, 95% CI, and p-values reported. RESULTS: The incidence of NNNM was 198 per 1000 live births. The significant risk factors associated with NNNM were higher education (AOR = 3.12, 95% CI: 1.84-5.28) for NNNM, referral from another facility (AOR = 4.45, 95% CI: 2.56-7.71), ≥ four ANC visits (AOR = 0.27, 95% CI: 0.09-0.87) Antenatal admission (AOR = 2.19, 95% CI: 1.16-4.10), having fetal monitoring during labour (AOR = 3.31, 95%CI: 1.99-5.49), HDP (AOR = 2.71, 95%Cl = 1.21-6.09). The neonatal outcome on the 28th day of life revealed that all newborns recruited in this study survived even though a significant number remained on admission in the NICU. CONCLUSIONS: The incidence of NNNM was high among our study population. The factors associated with NNNM were maternal education, ANC, pregnancy and delivery complications. Therefore, there is a need for policymakers and healthcare professionals to focus on NNNM by identifying life-threatening conditions for mothers and neonates during pregnancy, delivery, and the immediate postpartum period.