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Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria
ABSTRACT.
Neonatal mortality is a major contributor to under-five mortality, and Nigeria has the second-highest number of neonatal deaths globally. The country has introduced evidence-based interventions to improve newborn care over the years. The aim of this study was to determine the current trends in neonatal morbidity and mortality at the Lagos University Teaching Hospital, monitor progress over time, and identify areas for improvement. The admission registers and case files of all the neonatal ward admissions were reviewed from January 2018 to April 2020; the age at admission, gestational age, sex, inborn or out-born status, diagnosis, and outcome were recorded and analyzed. Of the 2,959 admissions during the study period, 68.4% were out-born and 77.9% were term gestation infants. The most common diagnoses were neonatal jaundice (NNJ; 28.4%), infection (28.0%), prematurity with associated complications (22.1%), and hypoxic ischemic encephalopathy (HIE; 18.2%). The overall mortality rate was 17.6%. Prematurity with associated complications (39.2%), HIE (24.8%), congenital anomalies (CAs; 12.7%), and NNJ (11.5%) were the most common conditions associated with mortality. Of those who died, the most common diagnoses among term infants were HIE (40.7%), CAs (21.8%), NNJ (18.9%), and infection (15.5%); respiratory distress syndrome (52.4%), infection (31.8%), and CAs (7.8%) were the most common diagnoses in preterm infants. The high risk of mortality with HIE, jaundice, infections, and CAs in this cohort reflects the national figures and trends. Efforts to improve neonatal care, especially respiratory support and education of the populace on NNJ, should be intensified to reduce neonatal mortality in the country.
Author Notes
Co-first authors.
Co-senior authors.
Authors’ addresses: Iretiola Bamikeolu Fajolu, Beatrice Nkolika Ezenwa, and Veronica Chinyere Ezeaka, Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria, and Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria, E-mails: ifajolu@unilag.edu.ng, bezenwa@unilag.edu.ng, and vezeaka@unilag.edu.ng. Katherine Megan Satrom and Angela Christine Kein, Department of Pediatrics, University of Minnesota, Minneapolis, MN, E-mails: ksatrom@umn.edu and angiekein@gmail.com. Tina Marye Slusher, Department of Pediatrics, Global Health Program, Critical Care Division, University of Minnesota, Minneapolis, MN, and Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, E-mail: tslusher@umn.edu.