El Ghazouani Hanane, Lahlou Laila, Yakini Souad, Bou-Iselmane Maryama, Elkhalladi Jaouad, Bouaiti El Arbi, Barkat Amina
Laboratory of Clinical Epidemiology and Medical-surgical Sciences, Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Laboratory of Health and Science, Therapeutic Innovation, Translational Research and Epidemiology, Faculty of Medicine and Pharmacy Ibn Zohr University, Agadir, Morocco.
J Taibah Univ Med Sci. 2025 Mar 6;20(2):151-158. doi: 10.1016/j.jtumed.2025.02.007. eCollection 2025 Apr.
Although neonatal mortality is declining globally, progress is slow, particularly in Africa. The goal of this study was to determine the predictive factors associated with survival in newborns at the Agadir Regional Hospital Centre, Morocco.
This retrospective cohort study performed at the neonatology department of the Agadir Regional Hospital Centre included neonates, from birth to 28 days old, who were hospitalized between January 1 and May 9, 2022. Prognostic factors were determined through univariate analysis with the Kaplan-Meier survival analysis method, and survival rates were compared with the log-rank test. The Cox model was used to determine factors associated with neonatal survival.
Of 639 enrolled newborns, 95.9 % were hospitalized during the first week of life. A total of 115 newborns died, resulting in an in-hospital neonatal mortality rate of 18 % (95 % CI [15.2-21.2]), and 98.3 % were early neonatal deaths. The factors associated with elevated death risk were perinatal asphyxia (HR = 2.61, 95 % CI [1.57-4.43], p < 0.001); prematurity (HR = 2.15, 95 % CI [1.17-3.94], p = 0.013); neonatal age ≤7 days (HR = 4.89, 95 % CI [1.14-20.94], p = 0.032); low birth weight (HR = 2.25, 95 % CI [1.28-3.94], p = 0.005); and hypothermia (HR = 7.60, 95 % CI [1.71-33.73], p = 0.008).
The neonatal mortality rate remains high. Developing the skills of healthcare providers, strengthening risk screening for pregnancies, and enhancing resuscitation and early care for newborns are essential to decrease neonatal mortality.
尽管全球新生儿死亡率在下降，但进展缓慢，尤其是在非洲。本研究的目的是确定摩洛哥阿加迪尔地区医院中心新生儿生存的预测因素。
这项回顾性队列研究在阿加迪尔地区医院中心新生儿科进行，纳入了2022年1月1日至5月9日期间住院的出生至28日龄的新生儿。通过单因素分析和Kaplan-Meier生存分析方法确定预后因素，并使用对数秩检验比较生存率。采用Cox模型确定与新生儿生存相关的因素。
在639名登记的新生儿中，95.9%在出生后第一周住院。共有115名新生儿死亡，院内新生儿死亡率为18%（95%CI[15.2-21.2]），98.3%为早期新生儿死亡。与死亡风险升高相关的因素包括围产期窒息（HR=2.61，95%CI[1.57-4.43]，p<0.001）；早产（HR=2.15，95%CI[1.17-3.94]，p=0.013）；新生儿年龄≤7天（HR=4.89，95%CI[1.14-20.94]，p=0.032）；低出生体重（HR=2.25，95%CI[1.28-3.94]，p=0.005）；以及体温过低（HR=7.60，95%CI[1.71-33.73]，p=0.008）。
新生儿死亡率仍然很高。提高医护人员的技能、加强孕期风险筛查以及加强新生儿复苏和早期护理对于降低新生儿死亡率至关重要。
