Neonatal Mortality: Experience of Pediatric Emergency Department

Abstract

Introduction: Neonatal mortality is a global health problem that has been at the heart of World Health Organization (WHO) programs for more than 30 years. In Morocco, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. We conducted this study to assess the prevalence of neonatal mortality, determine its causes and risk factors, and propose preventive measures to reduce this rate. Methods: This was a retrospective descriptive and analytical study conducted over a period of four and a half years, from January 2016 to June 2020, in the Pediatric Emergency Department of the Centre Hospitalier Universitaire Mohamed VI in Marrakech. Results: We recorded 268 deaths, representing a neonatal mortality rate of 18.3%, with a preponderance of early neonatal deaths (73.9%). The sex ratio was 1.45 in favor of males. Mean age at death was 6.5 days. 70% of pregnancies were poorly attended, medical deliveries accounted for 86% in our serie, and 90.5% of deliveries were vaginal. The majority of deaths occurred in parturients aged between 20 and 29 years (57.3%), and 28.5% of deaths occurred in primiparous women. The prematurity rate was 49.2%, and 58% of the newborns who died had a low birth weight. Prematurity was the leading cause of neonatal mortality (49.2%), followed by neonatal infection (38.5%) and perinatal asphyxia (12.3%). Conclusion: Effective management of pregnancy and the newborn in the first week of life should improve neonatal prognosis.