Factors associated with very early neonatal mortality in Burkina Faso: A matched case-control study.

OBJECTIVE: To identify the risk factors associated with very early neonatal death in Burkina Faso. METHODS: A matched case-control study including newborns born between May 2009 and April 2010. Cases comprised newborns that died within 24hours of birth, whereas controls were those of a similar birth weight to the cases who survived the first 24hours. Potential risk factors related to mothers, neonates, and healthcare provision were assessed from medical records and via interviews. Conditional logistic regression was used to estimate odds ratios. RESULTS: Data from 470 cases and 470 controls were analyzed. Multivariate analysis showed that Apgar score at 4-7 or 1-3 (aOR 6.27; 95% CI, 3.10-12.68 and aOR 72.26; 95% CI, 14.07-371.26, respectively); bradycardia at the last heart sound recorded before delivery (aOR 5.72; 95% CI, 1.42-23.03); inadequacy or lack of prenatal care (aOR 2.39; 95% CI, 1.15-4.97); resuscitation of newborns (aOR 2.07; 95% CI, 1.01-4.27); and referral of the newborn (aOR 5.29; 95% CI, 1.44-19.43) were associated with increased odds of neonatal mortality. However, being a primigravid mother (aOR 0.51; 95% CI, 0.29-0.89) was associated with decreased odds of neonatal mortality. CONCLUSION: Very early neonatal mortality is closely related to the condition of the newborn at birth, the monitoring of the pregnancy, and medical procedures.