Neonatal morbidity and mortality in the pediatric ward at the Ambohimiandra Antananarivo Madagascar hospital


  • Safidisoa N. Razanamanana Department of Medicine, University Ankatso, Antananarivo, Madagascar
  • Lovaniaina Ravelomanana Department of Medicine, University Ankatso, Antananarivo, Madagascar
  • Emilson JPR Andriatahirintsoa Department of Medicine, University Ankatso, Antananarivo, Madagascar
  • Noeline Ravelomanana Department of Medicine, University Ankatso, Antananarivo, Madagascar



Delivery, Morbidity, Newborn, Risk factor


Background: The 28 firsts days of life have high-risk of diverse aggression. To achieve the goal of ODD3 in reducing preventable neonatal death, our study was to evaluate main pathologies of newborn, newborn’s mortality.

Methods: This is a retrospective descriptive and analytical cross-sectional study extending over a period of 8 months, December 2014 to July 2015.

Results: We collected 132 newborn, the sex ratio was 1.13. Main newborn’s pathologies are neonatal infection (59.85%). Mortality rate was 14.39% and majority of neonatal death occurs early (73.68% of all deaths). Main causes of death are neonatal infection by septic shock. The most lethal pathology was hypoxic-ischemic encephalopathy. We have identified as a risk factor for neonatal death: admission age of 24 hours or less (OR 7; 95% CI 2.5-20.10; p = 0.00006), presence of resuscitation at birth (OR 3.48, 95% CI 1.28-9.44, p = 0.01), Apgar index less than 7 at the fifth minute (OR 4.22, 95% CI 2.25-14.87, p = 0.03) and birth weight less than 2500g (OR 3.80, 95% CI 1.39-10.36, p = 0.006).

Conclusions: The mortality rate remains high. The prevention of low birth weight, asphyxia and infections has shown strategies to reduce neonatal morbidity and mortality.


World Health Organisation. Newborn death and illness, make every mother and child count. WHO. 2011.

Kisito N, Fousséni D, François H. Ten years morbidity and mortality of newborns hospitalized at the Clinic El-Fateh Suka (Ouagadougou, Burkina Faso) Pan African Med J. 2013;14:153.

Champion V, Serfaty A, Gold F. Mortinatalité et mortalité néonatale. EMC Pédiatrie. 2011;4-002-F-50.

World Health Organisation. Fact sheet: Newborns: reducing mortality. WHO. Newborns: reducing mortality. 2017. Available at: mediacentre/factsheets/fs333/en/.

World Health Organisation. New data show child mortality rates falling faster than ever. WHO. 2016. Available at /releases/2014/child_mortality_estimates/fr/.

William M, Gary L. Darmstadt, David R, Robert EB, Mathuram S. Research priorities for the reduction of perinatal morbidity and mortality in developing country communities. J Perinatol. 2002;22:484.

Kouéta F, Diarra Y, Lassina D, Désiré N, Alphonse S. Neonatal morbidity and mortality in 2002-2006 at the Charles de Gaulle pediatric hospital in Ouagadougou (Burkina Faso). Cahiers Santé. 2007;17(4):187-91.

Koum D, Exhenry C, Penda C. Neonatal morbidity and mortality in a low-resource urban district hospital of Douala, Cameroon. Arch Pédiatr. 2014;21:147-56.

Yinger NV, Ransom ER. Why invest in newborn health? General policy Perspectives on newborn health. Washington (DC): Population Reference Bureau; Save the Children;2003.

UNICEF. Madagascar statistics. Available at:

World Health Organisation. Fact sheet: Children: reducing mortality. 2016;178. Available at:

Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries. Lancet. 2005 Mar 26;365(9465):1175-88.

Ravaoarisoa L, Tang Toy MA, Rakotonirina ECJ, Raobijaona HS, Rakotomanga JDM. Factors related to early neonatal mortality in the Obstetrics and Gynecology Teaching Hospital of Befelatanana, Antananarivo. Rev Anesth Réanim Med Urg. 2014;6(1):1-4.

Sidibé T, Sangho H, Doumbia S, Sylla M, Keita M, Keita HD, et al. Neonatal mortality in the health district of Kolokani (Mali). J Pédiatr Puéri. 2006;19:272Ŕ6.

Ndiaye O, Sall G, Diagne I, Diouf S, Kuakuvi N. Neonatal morbidity and mortality in Abass Ndao hospital center of Dakar (Sénégal). Arch Pédiatr. 2001;8:1019-20.

Blondel B, Eb M, Matet N, Bréart G, Jougla E. Neonatal mortality in France: usefulness of a neonatal death certificate Elsevier. Arch Pédiatr. 2005;12:1448-55.

Gizaw M, Molla M, Mekonnen W. Trends and risk factors for neonatal mortality in Butajira District, South Central Ethiopia,(1987-2008): a prospective cohort study. BMC pregnancy and childbirth. 2014 Dec;14(1):64.

Yenan JP, Plo KJ, Asse KV. Morbidity and neonatal mortality in service of pediatrics of Bouaké teaching hospital. 2014. Available at: /Morbidite-et-mortalite-neonatales.html. Accessed 23 April 2018.

Rabesandratana N, Zanasaotra S, Rakotoarisoa C, Ramilison F, Ravotsitindry L, Rafaralalao L and al. Morbidité et mortalité néonatale au CHU de Mahajanga, Madagascar. Bull Soc Pathol Exot. 2011;104:380-94.

Chelo D, Monebenimp F, Tedongmeza FRN, Tietche F. Early neonatal mortality and its determinants in a Level 1 maternity in Yaounde, Cameroon. Pan Afr Med J. 2012;13:67.

Lawn JE, Cousens S, Zupan J. Lancet Neonatal Survival Steering Team. 4 million neonatal deaths. when? Where? Why? Lancet. 2005;365(9462):891-900.

Saliba E, Lopez E, Storme L, Tourneux P, Favrais G. Physiologie du fetus et du nouveau-né- adaptation à la vie extra-utérine. EMC Pédiatrie. 2017;1-29.

Simunek V. Birth asphyxia in term newborns: Diagnosis, prognosis, neuroprotection. Arch Pediatr. 2010;17:578-82.

Boog G. Acute fetal pain. J Gynecol Obstet Biol Reprod. Masson. 2001;30:393-432.

Kayode GA, Ansah E, Agyepong IA, Amoakoh-Coleman M, Grobbee DE, Klipstein-Grobusch K. Individual and community determinants of neonatal mortality in Ghana: a multilevel analysis. BMC pregnancy and childbirth. 2014 Dec;14(1):165.

Ntambue A, Malonga F, Dramaix M, Donnen P. Perinatal mortality: Extent and causes in Lubumbashi, Democratic Republic of Congo. EMC, Rev Epidémio Santé Publique. 2013;61:519Ŕ29.

Blondel B, Bréart G. Fetal and neonatal mortality. EMC-Pédiatrie. 2004;01:97Ŕ108.

Serengbe B, Zindamoyen M, Diemer H, Adim N, Siopathis RM. Low birth weight newborns at Bangui. Méd Afrique Noire. 2000;47;4:191-5.

Chiabi A, Mah E, Ntsama Essoba M J, Nguefack S, Mbonda E, Tchokoteu PF. Factors associated with the survival of very low birth weight neonates at the Yaounde gynaeco-obstetric and pediatric hospital, Cameroon. Archives de Pédiatrie. 2014;21:142-6.




How to Cite

Razanamanana, S. N., Ravelomanana, L., Andriatahirintsoa, E. J., & Ravelomanana, N. (2018). Neonatal morbidity and mortality in the pediatric ward at the Ambohimiandra Antananarivo Madagascar hospital. International Journal of Research in Medical Sciences, 6(6), 1871–1876.



Original Research Articles