Socioeconomic Risk Factors for Hospital-based Neonatal Death: A Population-based Study

Abstract

Introduction: The aim of this study to review the socioeconomic determinants of neonatal death compared to living infants in a multinational’s population. Methods: A retrospective data analysis of 58,990 births. Population-based Cohort study retrieved from the perinatal registry for the 4 years period. We compared socio-economic factors in cases of neonatal death [NND] who died in the hospital with infants who have discharged alive from the hospital [AL]. Socioeconomic factors including nationality, religion, marital status, level of education, parents’ occupation, family income, consanguinity, early childbearing, smoking, assisted conception, antenatal care, and place of delivery. Results: There were 336 cases of ND and 58,654 of AL. The prevalence of NND was 5.7/1000 births. There were more neonatal deaths among uneducated mothers with P-value < 0.0003, and OR=2.0, mothers with low income (P=0.0008, CI=1.34-3.16, OR=2.07), families living in a shared houses (P=0.008, CI=1.23-3.19, OR=1.34), consanguinity (P=0.005, CI=1.13-2.0, OR=1.5), unemployed father (P=0.027, CI=1.24-4.28, OR=2.4), father’s education (P=0.017, CI=1.065-1.92, OR=1.4), assisted conception (P= 0.0001, CI=2.99-5.46, OR=4.04) and those mothers with no antenatal care (P=0.0001, CI=2.54-4.48, OR=3.37). Preterm birth in a referral/tertiary hospital was significantly high. There was no negative impact of nationality, mother’s occupation, maternal age, gravidity, or smoking. Comparing means among maternal and neonatal outcome categories showed no negative impact of crowding index (family members/number of rooms), number of rooms, number of family members, number of children in the house, or number of parties. Conclusion: In this study, antenatal care, parent’s education, father’s unemployment, low income of the mother, poor housing, consanguinity, assisted conception, and preterm birth were all associated with in-hospital neonatal death.