Factors associated with adverse neonatal outcome in a tertiary hospital of Nepal: Case Study

Abstract

Introduction: Neonatal outcomes are crucial indicators of maternal and child health, reflecting the quality of healthcare services. Adverse outcomes, like preterm birth, low birth weight, neonatal sepsis, and neonatal mortality, remain significant global challenges, especially in low- and middle-income countries (LMICs) like Nepal. Despite progress, Nepal’s neonatal mortality rate remains high at 21 per 1,000 live births, highlighting gaps in healthcare access and quality.

Objective: The objective of this study was to investigate factors associated with adverse neonatal outcomes in a tertiary hospital setting.

Methodology: A hospital-based case-control study was conducted in a tertiary hospital in Nepal from November 01, 2023 to April 30, 2024. Data were collected on sociodemographic and healthcare-related factors, maternal health pregnancy and obstetric related factors and analysed through IBM SPSS version 23. Chi square test and Odds ratios (ORs) was calculated. P Value <0.05 was considered statistically significant.

Results: Low birth weight (OR = 13.205, CI: 5.587–31.212), preterm delivery (OR = 13.17, CI: 5.808–29.880), twin pregnancies, missed antenatal care, lack of supplementation, deworming, maternal infections, per vaginal leaking, abnormal amniotic fluid, labor complications and referral cases showed significant associations (p < 0.05).

Conclusion: The study identifies key risk factors for adverse neonatal outcomes, including low birth weight, preterm delivery, twin pregnancies, inadequate antenatal care, lack of supplementation, maternal infections, and labor complications. Addressing these factors through targeted healthcare interventions could significantly improve neonatal health outcomes in resource-limited settings