Causes and Risk Factors for Neonatal Mortality– A Community based Case Control Study from Kollam, Kerala

Abstract

Research Question: What are the causes and risk factors for neonatal deaths Kollam district, Kerala?

Settings: Kollam district, Kerala with total population of 2.6 million, birth rate of 15/1000 population and a female literacy rate of 92%.

Study design: A community based case control study

Participants: A case was defined as a neonatal death among the permanent residents of the district during January 1ª to March 31 2013. Controls were chosen by simple random sampling from a sampling frame of all children who were born alive in the study population, +/- 7 days from the day of birth of the case and the baby being alive and well on the 28th day of life.

Methodology: Causes of neonatal deaths were ascertained based on information from death audits, hospital records and verbal autopsy. Mother's of cases and control were interviewed at their home using a structured questionnaire.

Results: A total of 40 neonatal deaths and 80 controls were studied. Prematurity (35%) and congenital anomalies (27.5%) were the major causes of neonatal deaths. History of previous infant death [OR 13.02 (95% CI 1.24-131.2)], premature rupture of membranes [OR 3.46 (95% CI 1.28-10.36)], Low birth weight [OR 3.12 (95% CI 1.42-8.48)], Prematurity [OR 2.78 (95% CI 1.09-7.12)] and domestic violence during pregnancy [OR 11.37 (95% CI 1.32-137.11)] were identified as significant risk factors for neonatal mortality in the current study.