title: Delivery outcomes and patterns of morbidity and mortality for neonatal admissions in five Kenyan hospitals.
abstract: A cross-sectional survey was conducted in neonatal and maternity units of five Kenyan district public hospitals. Data for 1 year were obtained: 3999 maternal and 1836 neonatal records plus tallies of maternal deaths, deliveries and stillbirths. There were 40 maternal deaths [maternal mortality ratio: 276 per 100 000 live births, 95% confidence interval (CI): 197-376]. Fresh stillbirths ranged from 11 to 43 per 1000 births. A fifth (19%, 263 of 1384, 95% CI: 11-30%) of the admitted neonates died. Compared with normal birth weight, odds of death were significantly higher in all of the low birth weight (LBW, <2500 g) categories, with the highest odds for the extremely LBW (<1000 g) category (odds ratio: 59, 95% CI: 21-158, p < 0.01). The observed maternal mortality, stillbirths and neonatal mortality call for implementation of the continuum of care approach to intervention delivery with particular emphasis on LBW babies.
authors.affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya jaluvaala@kemri-wellcome.org.
authors.forename: Jalemba
authors.initials: J
authors.lastname: Aluvaala
authors.affiliation: Kenya Paediatric Association.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Okello
authors.affiliation: Kenya Paediatric Association.
authors.forename: Gatwiri
authors.initials: G
authors.lastname: Murithi
authors.affiliation: Kenya Paediatric Association.
authors.forename: Leah
authors.initials: L
authors.lastname: Wafula
authors.affiliation: Kenya Paediatric Association.
authors.forename: Lordin
authors.initials: L
authors.lastname: Wanjala
authors.affiliation: Kenya Paediatric Association.
authors.forename: Newton
authors.initials: N
authors.lastname: Isika
authors.affiliation: Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
authors.forename: Aggrey
authors.initials: A
authors.lastname: Wasunna
authors.affiliation: Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
authors.forename: Fred
authors.initials: F
authors.lastname: Were
authors.affiliation: Ministry of Health, Government of Kenya.
authors.forename: Rachael
authors.initials: R
authors.lastname: Nyamai
authors.affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya Nuffield Department of Medicine, University of Oxford, Oxford, UK Department of Paediatrics, University of Oxford, Oxford, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: English
mesh_terms: D001237:Asphyxia / Q000453:epidemiology; D002423:Cause of Death; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008428:Maternal Mortality; D009017:Morbidity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*
keywords: Neonatal morbidity and mortality; developing countries; hospital care; maternal mortality; still births
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