Abstract
Background: With neonatal mortality static at 26/1000 live births between 2000 and 2019
against a target of 12 deaths/1000 live births by 2030, Zimbabwe is unlikely to achieve
Sustainable Development Goals 3.2 on good health, wellbeing and preventing of neonatal and
under five children mortality respectively. The study sought to determine the prevalence of
neonatal deaths and explore maternal factors and neonatal characteristics contributing to
neonatal deaths at two referral hospitals in Zimbabwe.
Method: A quantitative case control study was conducted at two referral hospitals with a
sample size of 918; Mbuya Nehanda Maternity Hospital neonatal care unit (MNMH, NICU)
n= 380; Sally Mugabe Maternity Hospital, Neonatal care unit (SMMH, NICU) n=538)
distributed between 41% cases (MNMH, n=190; SMMH n=269) and 49% controls (MNMH,
n=190, SMMH, n=269). Data were extracted from the birth registers and Neotree database,
managed and analysed using SPSS version 28 software. Logistic regression was used to assess
the association between neonatal characteristics, maternal factors, and neonatal mortality.
Results: 918 neonates records were analysed from MNMH and SMMH. Variables were
divided into socio demographics, neonatal characteristics, and clinical data for both maternal
and neonates. More males died (n=501) and majority of the neonates died in the first week of
life (AOR;1.82;95% CI:1.32 – 2.51). Neonatal characteristics that were statistically significant
included crying at birth, birth weight, APGAR score and born before arrival [(AOR:1.88; 95%
CI: 1.35– 2.64); (AOR:10.3; 95% CI: 6.1–17.5); (AOR:1.71; 95% CI: 1.15–2.57); AOR:17.4;
95% CI: 4.1–71.5)] respectively. Under Clinical data category, factors that were statistically
significant included gestation, low temperature, congenital abnormalities, PMTCT and parity
[(AOR:12.61; 95% CI:8.19–19.42); (AOR:1.7; 95% CI: 1.17–2.41); (AOR:0.19; 95% CI:
0.10–0.38); (AOR: 0.46; 95% CI: 0.30–0.71) and (AOR: 0.47; 95% CI: 0.30–0.72)]
respectively. There was a higher prevalence of congenital abnormality at SMMH (n=59) than
at MNMH(n=13). Neonates with gastroschisis recorded 94.6 % of deaths from those who were
born with congenital abnormalities, and Birth Asphyxia was listed as the highest cause of
neonatal deaths (17.2 %).
v
Conclusion: Most sociodemographic factors were not statistically associated with neonatal
mortality. The highest contributing condition to neonatal deaths was birth asphyxia. A number
of neonatal characteristics were associated with neonatal deaths including low birth weight and
low APGAR score. A high prevalence of mortality associated congenital abnormalities
(gastroschisis) from SMMH, NICU was noted which should be investigated.
Key Words:
Neonatal death, neonatal factors, maternal factors, Neotree, gestation, congenital
abnormalities, Oligohydramnios, resuscitation, gastroschisis, pre-natal, intrapartum