Neonatal Mortality and Associated Factors at a Tertiary-Level Neonatal Intensive Care Unit in Mogadishu, Somalia: A Retrospective Study.

Background: Neonatal mortality is a significant global health challenge, particularly in sub-Saharan Africa. In Somalia, there is a notable absence of comprehensive reports or data on neonatal mortality rates within tertiary-level neonatal intensive care units (NICU). This study aims to identify key factors associated with neonatal mortality in Mogadishu, Somalia. Materials and Methods: A retrospective review of medical records was conducted for neonates admitted to the Neonatal Intensive Care Unit (NICU) of Mogadishu Somali Turkish Training and Research Hospital from August 2017 to September 2019. Logistic regression analysis was employed using SPSS (version 25) to compute adjusted odds ratios (aORs) along with 95% confidence intervals (CIs). Results: Of 1043 neonates, 63.8% (n=665) were male, with a mean age of 1.48 days. Most neonates were full-term (55.3%, n=577), while 25.8% (n=269) were preterm (<32 weeks), and 11.9% (n=124) were late preterm (33-37 weeks). In total, 25.5% (n=266) had very low birth weight (<1500 grams). The average length of stay in the NICU was 7.38 days, and the overall mortality rate was 18.7% (n=195). Indications for NICU admissions were prematurity 27.0% (n=282), followed by birth asphyxia (18.0%, n=188), neonatal sepsis (14.6%, n=152), and acute respiratory distress syndrome (12.2%, n=127). Preterm neonates had significantly higher mortality rates (OR=2.14, 95% CI: 1.32-3.47, p=0.002), and those with a birth weight of <1500 grams had an even higher risk of mortality (OR=3.85, 95% CI: 2.50-5.92, p<0.001). Lack of ANC visits was associated with increased mortality risk (OR=1.67, 95% CI: 1.09-2.54, p=0.019), while cesarean delivery was also linked to higher mortality risk (OR=1.92, 95% CI: 1.29-2.85, p=0.002). Conclusion: The study identified a Neonatal Mortality Rate that is acceptable compared to the mortality rates in other studies in Somalia and the sub-Saharan African region. These findings inform care strategies and resource allocation in prenatal and neonatal health services.