Epidemiological Determinants and Risk Factors Contributing to the Rise in Neonatal Morbidity and Mortality in Liberia: A Quantitative Analysis

Background: Neonatal mortality has remained a significant public health challenge in Liberia, necessitating a thorough understanding of factors contributing to adverse neonatal outcomes. This study aimed to investigate demographic and clinical factors associated with neonatal mortality among infants admitted to the Neonatal Intensive Care Unit (NICU) in Liberia.  Objectives: The primary objective was to identify demographic and clinical factors associated with neonatal mortality in NICU admissions. Secondary objectives include assessing the impact of antenatal care and the follow-up, mode of delivery, gestational age at birth, and multiple births on neonatal mortality rates.  Methods: A retrospective analysis was conducted using data from NICU admissions in Liberia. Demographic and clinical variables, including sex of neonate, ANC follow-up, mode of delivery, multiple births, and gestational age at birth, were analyzed for their association with neonatal mortality using logistic regression models.  Keyresults: The study included various neonatal admissions to the NICU. While male neonates constituted a slight majority of admissions, gender did not significantly influence neonatal mortality rates. Lack of ANC follow-up emerged as a significant risk factor for mortality, with neonates whose mothers did not receive ANC showing a substantially higher risk. C-Section delivery was correlated with a significantly increased risk of neonatal mortality compared to spontaneous vaginal delivery. Preterm birth was also identified as a significant risk factor for mortality, highlighting the vulnerability of preterm neonates. Multiple births presented unique challenges but did not significantly impact mortality rates after adjustment.  Conclusion: This study underscored the critical importance of ANC follow-up, appropriate delivery practices, and specialized care for preterm neonates in reducing neonatal mortality rates in Liberia. Findings provided informed valuable insights for policymakers and healthcare practitioners to develop targeted interventions aimed at improving neonatal health outcomes and reducing mortality rates in the country.