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Cause‐specific neonatal morbidity and mortality in the Solomon Islands: An assessment of data from four hospitals over a three‐year period
Author(s) -
Tosif Shidan,
Jatobatu Annie,
Maepioh Anita,
Subhi Rami,
Francis Kate L,
Duke Trevor
Publication year - 2020
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.14699
Subject(s) - medicine , case fatality rate , pediatrics , asphyxia , referral , mortality rate , retrospective cohort study , neonatal sepsis , perinatal asphyxia , infant mortality , gestational age , sepsis , pregnancy , emergency medicine , obstetrics , population , environmental health , family medicine , biology , genetics
Aim Data on stillbirths and neonatal morbidity and mortality in low‐middle income Pacific Island Nations such as Solomon Islands is limited, partly due to weak health information systems. We describe the perinatal mortality and clinical factors associated with poor newborn outcomes at four hospitals in Solomon Islands. Methods This was a registry based retrospective cohort study at three provincial hospitals and the National Referral Hospital (NRH) from 2014–2016 inclusive. Results 23 966 labour ward births and 3148 special care nursery (SCN) admissions were reviewed. Overall still birth rate was 29.2/1000 births and the perinatal mortality rate was 35.9/1000 births. PNMR were higher in provincial hospitals (46.2, 44.0 and 34.3/1000) than at NRH (33.3/1000). The commonest reasons for admission to SCN across the hospitals were sepsis, complications of prematurity and birth asphyxia. SCN mortality rates were higher in the 3 provincial hospitals than at NRH (15.9% (95/598) vs. 7.9% (202/2550), P value <0.01). At NRH, the conditions with the highest case fatality rates were birth asphyxia (21.3%), congenital abnormalities (17.7%), and prematurity (15.1%). Up to 11% of neonates did not have a diagnosis recorded. Conclusions The perinatal mortality rates are high and intrapartum complications, prematurity and sepsis are the main causes of morbidity and mortality for neonates at hospitals in Solomon Islands. Stillbirths account for 81% of perinatal deaths. These results are useful for planning for quality improvement at provincial level. Improved vital registration systems are required to better capture stillbirths and neonatal outcomes.