Comparison of early vs. Late neonatal death in relation to etiological causes in a tertiary care hospital

Abstract

Background: Early neonatal death, defined as the death of a newborn between zero and seven days after birth, represents 73% of all postnatal deaths worldwide.

Objective: determine the neonatal death rate per-1000 live births and to compare the causes of mortality between neonates with early versus late neonatal death.

Methods: This is an observational, comparative, retrospective, and cross-sectional study. The records of all neonatal deaths that occurred from January 1, 2020, to December 31, 2024, were analyzed. The general variables were age, weight, sex, and muscle mass. The specific variables were cardiac, respiratory, neurological, gastrointestinal, and infectious pathologies. Binary logistic regression was performed for variables with statistical significance.

Results: During the study period, there were 20,583 births with 330 deaths, representing a rate of 16 per-1,000 live births. Of these, 235 (71.2%) resulted in early neonatal death. Binary logistic regression analysis showed that neonates with early neonatal death had a higher mortality rate (p<0.05) in the 24–25 weeks gestational age range and were more frequently affected by respiratory distress syndrome (63.8% vs. 26.3%). The most frequent causes of neonatal mortality overall were respiratory problems (n=247), infections (n=157), and congenital malformations (n=125).

Conclusions: The neonatal mortality rate was 16 per-1,000 live births. Most deaths were early, up to 71.2%. Newborns with early neonatal death had a higher incidence of respiratory distress syndrome. The three most frequent causes were respiratory problems, infections, and congenital malformations, respectively.