Factors Associated with Intra Hospital Neonatal Mortality: A Case Study of the Neonatology Department at the Regional Hospital Center of Agadir (Morocco)

Background: Neonatal mortality (NNM) has significantly decreased in developed countries. However, it remains a major public health issue and a particular challenge in developing countries, with Morocco being no exception, as its NNM rate remains high. Objectives: This study aims to identify factors associated with NNM within the Neonatology Department at the Regional Hospital Center of Agadir. Methods: An analytical cross-sectional study design was chosen. To determine factors associated with early NNM, we employed binary logistic regression in both univariate and multivariate analyses, including all statistically significant variables in the multivariate model. Results: Three hundred and eight deceased neonates were included. The intra-hospital NNM rate was 17.4%, 95% CI (13.2 - 21.7), during the period from 2018 to 2021. A predominance of early NNM (81.8%). 52.3% were females. 47.7% of the deceased had low birth weight. 65.9% of the cases had an Apgar score < 7. 44.2% were resuscitated. The factors that were statistically associated with the risk of early NNM were as follows: Admission age ≤ 1 day (aOR: 17.87; 95% CI: 5.78 - 55.29), neonatal admission age 2 - 7 days (aOR: 6.64; 95% CI: 1.68 - 26.30). Intra-hospital referral (aOR: 4.49; 95% CI: 1.59 - 12.65); emergency consultations (aOR: 4.25; 95% CI: 1.28 - 14.01). Conclusions: Neonatal mortality remains a major public health challenge in Morocco. Different risk factors associated with NNM have been identified. Addressing these factors could reduce neonatal deaths in low-resource countries. For this reason, we need to intensify our efforts to develop reliable and precise approaches.