Risk factors of perinatal and neonatal mortality in Alexandria, Egypt

Egypt has already achieved the goal of reducing the under-five mortality rate (U5MR) by two-thirds. However, one of the challenges that Egypt currently faces is how to reduce the perinatal and neonatal mortality (PM, NM). This study aimed to identify the social and biomedical risk factors contributing toward PM and NM in Alexandria, Egypt.

A case-control design was used. Cases were 150 mothers whose index pregnancy terminated in perinatal (from the 28th week of pregnancy to less than 7 days after birth) and neonatal deaths (from the seventh day to less than the 28th day after birth). They were selected from the antenatal clinic and neonatal care unit of ElShatby University hospital for Obstetrics and gynecology. Controls were 150 mothers with live births ranging in age from 28 days up to 2 months selected from the outpatient clinics of ElShatby University Hospital for Pediatrics.

Stepwise logistic regression analysis indicated a higher risk of PM/NM among very young or very old mothers (OR=4.1 and 6.46, respectively), those who had previous PM/NM [odds ratio (OR)=12.7; 95% confidence interval (CI): 5.04-29.54], grand multiparous (OR=2.23; 95% CI: 1.50-5.42), those with infrequent antenatal visits (OR=3.88; 95% CI: 2.26-6.65), and mothers with complications during the index pregnancy (OR=9.21; 95% CI: 3.40-24.95).

This study confirms the evidence of a positive association between PM/NM and maternal age, obstetric history, and utilization of healthcare services. Appropriate age at marriage and pregnancy, spacing of and limiting the number of births, and improving antenatal, natal, and postnatal care are priority actions that can reduce PM/NM in Alexandria.