ArticleWellcome open research2026
Outborn Neonates in Nairobi's Public Hospitals: Mortality Burden and Risk Factors.
Article in Wellcome open research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Background: Neonatal mortality remains a significant challenge in Sub-Saharan Africa. Outborn neonates - those born outside the admitting hospital - are particularly vulnerable, yet their outcomes remain under-characterized in many low-resource urban settings. This study examines the burden, characteristics, and mortality risk among outborn neonates admitted to public neonatal units in Nairobi, Kenya. Methods: We conducted a retrospective cohort study across four high-volume public hospitals in Nairobi County, Kenya. A stratified random sample of 400 outborn neonates admitted between January and December 2023 was reviewed using medical records. To estimate outborn prevalence and the Population Attributable Fraction (PAF) for mortality, we analyzed registry data from 9,021 neonatal admissions with complete outcome and place-of-birth information. Referral distances were calculated using geocoded coordinates of referring and receiving facilities. Multivariable logistic regression identified factors independently associated with inpatient neonatal mortality. Results: Outborn neonates accounted for 17% of neonatal admissions, with a mortality rate of 25.6%, double that of inborn (12.5%; crude RR=2.05, p<0.001). The PAF was 15.0% (95% CI: 12.3-17.7%), indicating that one in seven neonatal deaths could be attributed to outborn status. Key factors were significantly associated with increased odds of mortality including; extremely low birth weight (<1000g; AOR=7.8, 95% CI: 2.6, 23), very low birth weight (1000-1499g; AOR= 4.7 95% CI:2.3, 9.7), hypothermia (AOR=2.2, 95% CI: 1.1, 4.5), respiratory distress (AOR=2.1, 95% CI: 1.2, 3.8), and referral distance >12.1 km (AOR=2.6, 95% CI: 1.1, 6.6). Most deaths (68%) occurred within three days of admission. Conclusion: Outborn neonates in Nairobi's public hospitals face substantially higher early mortality, primarily driven by low birth weight, hypothermia, respiratory distress, and longer referral distances. Interventions targeting improved stabilization, timely referral, and early neonatal care are urgently needed. These findings provide actionable evidence to inform policies aimed at reducing neonatal mortality and advancing progress toward SDG 3.2.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.