Preventable maternal and neonatal factors of early and late neonatal mortality in rural city of Tshumbe, Sankuru Province, Democratic Republic of the Congo.

BACKGROUND: The first 28 days of life, known as the neonatal period, is most vulnerable time for child's survival. Prematurity, infections, and respiratory distress are the most important causes of neonatal death. AIM: This study aimed to evaluate preventable maternal and neonatal factors of early and late neonatal mortality in Rural city of Tshumbe, Sankuru Province, Democratic Republic of the Congo. METHODS: This retrospective observational study was conducted between January 1, 2022 to December 31, 2024, in three health centres. Maternity ward recorded 1827 births, of which 369 neonates were admitted to pediatrics, and 246 neonate deaths within the first 28 days were documented. Multivariate analysis was performed to evaluate the association between maternal and neonatal factors on neonatal mortality. RESULTS: Malaria in pregnancy and urogenital infection accounted for 85.77%, and 72.36% of neonatal deaths, respectively (p = 0.001) (p < 0.05). Association between paludism in pregnancy (aOR: 4.12, 95% CI: 1.71;9.89), hypotrophic birth weight, (aOR: 2.00, 95% CI: 1.02;3.91), very premature (aOR: 2.13; 95% CI: 1.04;4.37), zero prenatal visit (aOR: 3.57, 95% CI: 1.30; 9.77) and early neonatal mortality were found. Additionally, the risk of early neonatal mortality decreased for women with a history of two to three vaccination (aOR: 0.18, 95%CI:1.62; 6.26). CONCLUSION: Significantly higher rates of early mortality were revealed among respondents with no prenatal visits. Furthermore, malaria in pregnancy, low birth weight and very preterm birth were associated with early neonatal mortality. In addition, the risk of early neonatal mortality decreased with increasing tetanus vaccination coverage among women.