{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:09:40Z","timestamp":1763644180581,"version":"3.41.2"},"reference-count":76,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Neonatal mortality reduction is a global goal, but its factors are seldom studied in most resource-constrained settings. This is the first study conducted to identify the factors affecting perinatal and neonatal deaths in Sao Tome &amp;amp; Principe (STP), the smallest Central Africa country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Institution-based prospective cohort study conducted at Hospital Dr. Ayres Menezes. Maternal-neonate dyads enrolled were followed up after the 28th day of life (<jats:italic>n<\/jats:italic>\u2009=\u2009194) for identification of neonatal death-outcome (<jats:italic>n<\/jats:italic>\u2009=\u200922) and alive-outcome groups (<jats:italic>n<\/jats:italic>\u2009=\u2009172). Data were collected from pregnancy cards, hospital records and face-to-face interviews. After the 28th day of birth, a phone call was made to evaluate the newborn's health status. Crude odds ratios and corresponding 95% confidence intervals were obtained. A <jats:italic>p<\/jats:italic> value &amp;lt;0.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean gestational age of the death-outcome and alive-outcome groups was 36 (SD\u2009=\u20094.8) and 39 (SD\u2009=\u20091.4) weeks, respectively. Death-outcome group (<jats:italic>n<\/jats:italic>\u2009=\u200922) included sixteen stillbirths, four early and two late neonatal deaths. High-risk pregnancy score [cOR 2.91, 95% CI: 1.18\u20137.22], meconium-stained fluid [cOR 4.38, 95% CI: 1.74\u201310.98], prolonged rupture of membranes [cOR 4.84, 95% CI: 1.47\u201315.93], transfer from another unit [cOR 6.08, 95% CI:1.95\u201318.90], and instrumental vaginal delivery [cOR 8.90, 95% CI: 1.68\u201347.21], were factors significantly associated with deaths. The odds of experiencing death were higher for newborns with infectious risk, IUGR, resuscitation maneuvers, fetal distress at birth, birth asphyxia, and unit care admission. Female newborn [cOR 0.37, 95% CI: 0.14\u20131.00] and birth weight of more than 2,500\u2005g [cOR 0.017, 95% CI: 0.002\u20130.162] were found to be protective factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Factors such as having a high-risk pregnancy score, meconium-stained amniotic fluid, prolonged rupture of membranes, being transferred from another unit, and an instrumental-assisted vaginal delivery increased 4\u2013 to 9\u2013fold the risk of stillbirth and neonatal deaths. Thus, avoiding delays in prompt intrapartum care is a key strategy to implement in Sao Tome &amp;amp; Principe.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1335926","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T05:01:08Z","timestamp":1708059668000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors associated with perinatal and neonatal deaths in Sao Tome &amp; Principe: a prospective cohort study"],"prefix":"10.3389","volume":"12","author":[{"given":"Alexandra","family":"Vasconcelos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swasilanne","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"Bandeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Lu\u00edsa","family":"Papoila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filomena","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C\u00e9u","family":"Machado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-017-1420-7","article-title":"Factors associated with perinatal mortality among public health deliveries in Addis Ababa, Ethiopia, an unmatched case control study","volume":"17","author":"Getiye","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"B2","doi-asserted-by":"publisher","first-page":"6027","DOI":"10.1016\/j.vaccine.2016.03.040","article-title":"Neonatal death: case definition & guidelines for data collection, analysis, and presentation of immunization safety data","volume":"34","author":"Pathirana","year":"2016","journal-title":"Vaccine"},{"volume-title":"Every New Born: An Action Plan to End Preventable Deaths","year":"2014","key":"B3"},{"key":"B4","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.siny.2017.02.006","article-title":"Early neonatal death: a challenge worldwide","volume":"22","author":"Lehtonen","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/S0140-6736(21)01112-0","article-title":"Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment","volume":"398","author":"Hug","year":"2021","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.2147\/IJWH.S276638","article-title":"Determinants of stillbirth among deliveries attended in bale zone hospitals, Oromia regional state, Southeast Ethiopia: a case\u2013control study","volume":"13","author":"Dagne","year":"2021","journal-title":"Int J Women\u2019s Health"},{"key":"B7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1471-0528.2009.02328.x","article-title":"Newborn survival in low resource settings\u2014are we delivering?","volume":"116","author":"Lawn","year":"2009","journal-title":"BJOG: An Int J Obstet Gynaecol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/S0140-6736(05)71048-5","article-title":"Lancet neonatal survival steering team. 4 million neonatal deaths: when? 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