ArticlePublic health in practice (Oxford, England)2026
Determinants of neonatal morbidity in Rajshahi Division of Bangladesh.
Article in Public health in practice (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Neonatal morbidity (NM) refers to any clinically identified health complication that occurs within the first 28 days of life after birth. It remains a significant public health challenge in low and middle-income countries such as Bangladesh. This study aimed to investigate the determinants of NM in the Rajshahi Division of Bangladesh, with a particular focus on socio-demographic characteristics, maternal health, delivery practices and breastfeeding behaviors. Study design: A population-based cross-sectional study. Methods: Data were collected from 475 mothers in selected hospitals using a multi-stage sampling technique. Information was collected through structured questionnaires and medical records at two time points: 3 days and 28 days after birth. Descriptive statistics summarized participant characteristics. Chi-square tests and binary logistic regression were used to explore associations between key variables and NM. Results: The overall neonatal morbidity rate was 53.6 %. Maternal age, mode of delivery, delivery attendance and breastfeeding practices were significant determinants of NM. Infants born to mothers aged 25-29 years had significantly lower odds of NM (OR = 0.192, 95 % CI: 0.043-0.855) compared with those born to mothers aged ≥35 years. Vaginal delivery was associated with higher odds of NM than caesarean section (OR = 1.934, 95 % CI: 1.334-2.829) whereas deliveries attended by both a doctor and a nurse were associated with lower odds (OR = 0.366, 95 % CI: 0.204-0.655) of morbidity. Exclusive breastfeeding and early initiation of breastfeeding with the first hour after birth were associated with lower odds of NM compared with non-exclusive breastfeeding and delayed initiation (OR = 0.521, 95 % CI: 0.343-0.794; OR = 0.588, 95 % CI: 0.351-0.985, respectively). Furthermore, infants who were fed on demand had markedly lower odds of neonatal morbidity (OR = 0.145, 95 % CI: 0.031-0.671). Conclusions: NM in the Rajshahi division is influenced by maternal age, delivery method, delivery attendance and breastfeeding practices. Policies and programs promoting skilled delivery attendance and optimal breastfeeding support are essential to reduce NM and improve neonatal health outcomes in this region.
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