Abstract
BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsVerbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10).ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and164 (5.1%) died in the first 28 days of life. VASA was conducted among 88 (53.7%) of the neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 h of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths.ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.
Highlights
Under-five mortality in Kenya has declined over the past two decades
Deaths among low birth weight (LBW) and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia
This study aimed to determine the causes of death among preterm and low birth weight (LBW) neonates born in selected health facilities in Migori county between January 1, 2017, to December 31, 2018
Summary
Under-five mortality in Kenya has declined over the past two decades. the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. The World Health Organization (WHO) estimates that 15 million babies are born preterm annually and approximately one million succumb to death in their first 4 weeks of life due to complications of prematurity[1]. Preterm birth has been reported to be the leading cause of neonatal death [1,2,3,4,5]. Preterm babies born in developed countries have almost ten times better survival rates compared to those born in low-resource settings ([4] http://www.who.int/maternal_child_adolescent/documents/born_too_soon/en/). Most deaths in preterm babies in the developing nations occur from preventable causes such as infection, asphyxia, hypothermia, and hypoglycemia. > 80% are born between 32 and 37 weeks of gestation (moderate/late preterm), and many die needlessly for lack of simple, essential care such as warmth and feeding support [10]
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