Determinants of neonatal mortality in East Azarbaijan province: a population-based study from Iran

BACKGROUND: Neonatal mortality continues to pose a major challenge to achieving global sustainable development goals, especially in low- and middle-income countries. Consequently, this study focused on examining the factors influencing neonatal mortality in the East Azarbaijan province, Iran. METHODS: A cross-sectional study based on population data was conducted utilizing the Iranian Maternal and Neonatal (IMAN) Network data (2018–2019). A multilevel binary logistic analysis was employed to determine the key factors influencing neonatal mortality. Adjusted Odds Ratios and population attributable risk (PAR) for the identified risk factors were presented. RESULTS: The neonatal mortality rate in East Azarbaijan province was 7.37 deaths per 1000 live births. Multivariate analysis indicated that neonates weighing less than 1000 g at birth with OR = 35.23 (PAR = 20.14%); 1000–1500 gram with OR = 12.85 (PAR = 8.03%) and 1500–2500 gram with OR: 3.24 (PAR = 1.62%), babies born with gestational age < 28 weeks was OR = 13.28 (PAR = 8.29%), 28–31 weeks OR = 6.81 (PAR = 4.10), 32–36 weeks OR = 4.33 (PAR = 2.39), male neonates OR = 1.41 (PAR = 0.30), stillbirth history of mothers OR = 2.24 (PAR = 0.90) were significantly associated with higher odds of neonatal mortality. CONCLUSION: The current study identified significant factors such as birth weight, gestational age, and a history of stillbirths among mothers as contributors to increased neonatal mortality. Prematurity (gestational age of < 37 weeks) and low birth weight (< 2500 g) together account for approximately 45% of the risk of neonatal deaths. Strategies to reduce neonatal mortality should prioritize the prevention of preterm births.