title: Incidence and risk factors for early neonatal mortality in newborns with severe perinatal morbidity in Uganda.
abstract: OBJECTIVE
  To determine the incidence and risk factors for early neonatal death among newborns with severe perinatal morbidity.
  
  
  METHODS
  A prospective cohort study was performed of 341 newborns with severe perinatal morbidity admitted to the neonatal intensive care unit of Mulago Hospital, Uganda. All newborns were followed up for 7 days or until time of death. Information surrounding the mother's obstetric history and pregnancy, the birth, and the neonatal history was collected using an interviewer-administered questionnaire and by review of relevant records. Multivariate logistic regression analysis was performed to assess factors independently associated with early neonatal death.
  
  
  RESULTS
  A total of 37 (10.9%) neonates died within 7 days, giving an incidence of early neonatal death of 109 deaths per 1000 live births (3 per 100 person-days). In multivariate analysis, respiratory distress (adjusted risk ratio [aRR] 31.29; 95% CI, 4.17-234.20; P=0.001) and inadequate fetal heart monitoring during labor (aRR 6.0; 95% CI 1.40-25.67; P=0.016) were significantly associated with an increased risk of early neonatal death.
  
  
  CONCLUSIONS
  Approximately one in 10 neonates with severe perinatal morbidity died within 7 days of birth. Respiratory distress and poor monitoring of labor were risk factors for early neonatal death.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: bamusooko@yahoo.com.
authors.forename: Moses
authors.initials: M
authors.lastname: Musooko
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Othman
authors.initials: O
authors.lastname: Kakaire
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Annettee
authors.initials: A
authors.lastname: Nakimuli
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nakubulwa
authors.affiliation: Department of Pediatrics and Child Health Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Jolly
authors.initials: J
authors.lastname: Nankunda
authors.affiliation: Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Osinde
authors.affiliation: Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Scovia N
authors.initials: SN
authors.lastname: Mbalinda
authors.affiliation: Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, Kampala, Uganda.
authors.forename: Nelson
authors.initials: N
authors.lastname: Kakande
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality; D007363:Intensive Care Units, Neonatal; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors; D050497:Stillbirth / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: Incidence; Neonatal mortality; Neonatal near-miss morbidity; Perinatal morbidity; Quality of newborn care; Risk factors