{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:45:19Z","timestamp":1769633119915,"version":"3.49.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Preterm birth continues to be a leading cause of death for children under the age of 5 globally. This issue carries significant economic, psychological, and social costs for the families affected. Therefore, it is important to utilize available data to further research and understand the risk factors for preterm death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to determine maternal and infant complications that influence preterm deaths in a tertiary health facility in Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of data on preterm newborns was conducted at the neonatal intensive care unit of Korle Bu Teaching Hospital (KBTH NICU) in Ghana, covering the period January 2017 to May 2019. Pearson's Chi-square test of association was used to identify factors that were significantly associated with preterm death after admission at the NICU. The Poisson regression model was used to determine the risk factors of preterm death before discharge after admission to the NICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1,203 preterm newborns admitted to the NICU in about two and half years, 355 (29.5%) died before discharge, 7.0% (<jats:italic>n<\/jats:italic> = 84) had normal birth weight (&amp;gt;2.5 kg), 3.3% (<jats:italic>n<\/jats:italic> = 40) had congenital anomalies and 30.5% (<jats:italic>n<\/jats:italic> = 367) were born between 34 and 37 gestational week. All 29 preterm newborns between the 18\u201325 gestational week died. None of the maternal conditions were significant risk factors of preterm death in the multivariable analysis. The risk of death at discharge was higher among preterm newborns with complications including hemorrhagic\/hematological disorders of fetus (aRRR: 4.20, 95% CI: [1.70\u201310.35], <jats:italic>p<\/jats:italic> = 0.002), fetus\/newborn infections (aRRR: 3.04, 95% CI: [1.02\u20139.04], <jats:italic>p<\/jats:italic> = 0.046), respiratory disorders (aRRR: 13.08, 95% CI: [5.50\u201331.10], <jats:italic>p<\/jats:italic> &amp;lt; 0.001), fetal growth disorders\/restrictons (aRRR: 8.62, 95% CI: [3.64\u201320.43], <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and other complications (aRRR: 14.57, 95% CI: [5.93\u201335.77], <jats:italic>p<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrate that maternal factors are not significant risk factors of preterm deaths. Gestational age, birth weight, presence of complications and congenital anomalies at birth are significantly associated with preterm deaths. Interventions should focus more on child health conditions at birth to reduce the death of preterm newborns.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1108744","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T07:30:37Z","timestamp":1675927837000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Maternal factors and child health conditions at birth associated with preterm deaths in a tertiary health facility in Ghana: A retrospective analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Seth Kwaku","family":"Afagbedzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yakubu","family":"Alhassan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deda Ogum","family":"Alangea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrietta","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"263ed","DOI":"10.1126\/scitranslmed.aaa2563","article-title":"Preterm birth: now the leading cause of child death worldwide","volume":"6","author":"Lawn","year":"2014","journal-title":"Sci Transl Med."},{"key":"B2","volume-title":"Levels and Trends in Child Mortality: Report 2017","year":"2017"},{"key":"B3","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/S0140-6736(14)61698-6","article-title":"Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: An updated systematic analysis","volume":"3856","author":"Liu","year":"2015","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications","volume":"3792","author":"Blencowe","year":"2012","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/S2214-109X(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"Chawanpaiboon","year":"2019","journal-title":"Lancet Glob Health."},{"key":"B6","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1053\/j.semperi.2010.09.011","volume":"34","author":"Lawn","year":"2010","journal-title":"Sem Perinatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1186\/s12887-014-0312-5","article-title":"Perinatal factors associated with early neonatal deaths in very low birth weight preterm infants in Northeast Brazil","volume":"14","author":"Castro","year":"2014","journal-title":"BMC Pediatr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"881","DOI":"10.2147\/IJWH.S72229","article-title":"Prevalence and perinatal mortality associated with preterm births in a tertiary medical center in South East Nigeria","volume":"6","author":"Iyoke","year":"2014","journal-title":"Int J Womens Health."},{"key":"B9","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1097\/AOG.0b013e3181b473fc","article-title":"Heterogeneity of preterm birth subtypes in relation to neonatal death","volume":"114","author":"Chen","year":"2009","journal-title":"Obstet Gynecol."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001292","article-title":"Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis","author":"Marchant","year":"","journal-title":"PLoS Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4236\/ojped.2014.41009","article-title":"Prevalence and outcome of preterm admissions at the neonatal unit of a tertiary health Centre in Southern Nigeria","volume":"4","author":"Kunle-Olowu","year":"2014","journal-title":"Open J Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1111\/j.1600-0412.2012.01478.x","article-title":"Factors associated with and causes of perinatal mortality in northeastern Tanzania","volume":"91","author":"Schmiegelow","year":"2012","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B13","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.clp.2011.06.009","article-title":"Morbidity and mortality in late preterm and early term newborns: a continuum","volume":"38","author":"Engle","year":"2011","journal-title":"Clin Perinatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.placenta.2019.01.007","article-title":"Determinants and outcomes of preterm births at a tertiary hospital in Ghana","volume":"79","author":"Adu-Bonsaffoh","year":"2019","journal-title":"Placenta."},{"key":"B15","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/1471-2393-14-56","article-title":"Maternal morbidity and preterm birth in 22 low- and middle-income countries: a secondary analysis of the WHO Global Survey dataset","volume":"14","author":"Vogel","year":"2014","journal-title":"BMC Pregnancy Childbirth."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1111\/j.1524-4733.2009.00580.x","article-title":"Costs and health utilities associated with extremely preterm birth: evidence from the EPICure study","volume":"12","author":"Petrou","year":"2009","journal-title":"Value Health."},{"key":"B17","doi-asserted-by":"publisher","first-page":"F329","DOI":"10.1136\/fetalneonatal-2011-300969","article-title":"Study of the costs and morbidities of late-preterm birth","volume":"97","author":"B\u00e9rard","year":"2012","journal-title":"Arch Dis Childhood-Fetal Neonatal Edition."},{"key":"B18","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/EDE.0b013e3181debe5e","article-title":"Mortality risk among preterm babies: immaturity versus underlying pathology","volume":"21","author":"Basso","year":"2010","journal-title":"Epidemiology."},{"key":"B19","first-page":"43","article-title":"A five-year neonatal mortality trend in a Ghanaian Teaching Hospital after the implementation of strategies to achieve the Millenium Development Goal (MDG) 4","volume":"2","author":"Siakwa","year":"2014","journal-title":"Int J Paediatr Child Health."},{"key":"B20","volume-title":"Ghana National Newborn Health Strategy and Action Plan 2014-2018: A Road Map to Reduce Neonatal Deaths Nationwide","year":"2014"},{"key":"B21","author":"Every","year":"2019","journal-title":"Ghana: Profile of Preterm and Low Birth Weight Prevention and Care. Connecticut"},{"key":"B22","article-title":"Maternal and Newborn Health Disparities: Ghana, Accra: UNICEF","year":""},{"key":"B23","year":"2019","journal-title":"ICD-11 for Mortality and Morbidity Statistics (Version: 04\/2019)."},{"key":"B24","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1542\/peds.2007-3743","article-title":"Perinatal outcomes associated with preterm birth at 33 to 36 weeks' gestation: a population-based cohort study","volume":"123","author":"Khashu","year":"2009","journal-title":"Pediatrics."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e58924","DOI":"10.1371\/journal.pone.0058924","article-title":"Why Are Babies Dying in the First Month after Birth? A 7-Year Study of Neonatal Mortality in Northern Ghana","volume":"8","author":"Welaga","year":"2013","journal-title":"PLoS ONE."},{"key":"B26","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/10158782.2011.11441416","article-title":"Causes of neonatal admissions and deaths at a rural hospital in KwaZulu-Natal, South Africa","volume":"26","author":"Hoque","year":"2011","journal-title":"S Afr J Epidemiol Infect."},{"key":"B27","volume-title":"Ghana Maternal Health Survey 2017: Key Indicators Report","year":"2018"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1001\/jamapsychiatry.2013.2107","article-title":"Preterm Birth and Mortality and Morbidity","volume":"70","author":"D'Onofrio","year":"2013","journal-title":"JAMA Psychiatry."},{"key":"B29","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1097\/AOG.0b013e3181af6931","article-title":"Short-term neonatal outcome in low-risk, spontaneous, singleton, late preterm deliveries","volume":"114","author":"Melamed","year":"2009","journal-title":"Obstet Gynecol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.jpeds.2007.05.002","article-title":"Differences in mortality between late-preterm and term singleton infants in the United States, 1995\u20132002","volume":"151","author":"Tomashek","year":"2007","journal-title":"J Pediatr."},{"key":"B31","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1097\/01.AOG.0000295866.97499.35","article-title":"Extreme Preterm Birth: Onset of Delivery and its Effect on Infant Survival and Morbidity","volume":"111","author":"Johanzon","year":"2008","journal-title":"Obstetr Gynecol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e59","DOI":"10.1542\/peds.2014-2967","article-title":"Etiologies of NICU Deaths","volume":"135","author":"Jacob","year":"2015","journal-title":"Pediatrics."},{"key":"B33","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/AOG.0000000000001179","article-title":"Cause of preterm birth as a prognostic factor for mortality","volume":"127","author":"DelormeP","year":"2016","journal-title":"Obstetr Gynecol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e584","DOI":"10.1542\/peds.2009-0449","article-title":"Early hyperglycemia is a risk factor for death and white matter reduction in preterm infants","volume":"125","author":"Alexandrou","year":"2010","journal-title":"Pediatrics."},{"key":"B35","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1038\/jp.2008.18","article-title":"Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure","volume":"28","author":"Ambalavanan","year":"2008","journal-title":"J Perinatol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jpeds.2011.06.046","article-title":"Deaths in preterm infants: changing pathology over 2 decades","volume":"160","author":"Berrington","year":"2012","journal-title":"J Pediatr"},{"key":"B37","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12887-017-0810-3","article-title":"Causes of death in very preterm infants cared for in neonatal intensive care units: a population-based retrospective cohort study","volume":"17","author":"Schindler","year":"2017","journal-title":"BMC Pediatr."},{"key":"B38","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.rppede.2015.12.008","article-title":"Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil","volume":"34","author":"Castro","year":"2016","journal-title":"Revista Paulista de Pediatria (English Edition)."},{"key":"B39","doi-asserted-by":"publisher","first-page":"S533","DOI":"10.1177\/15648265090304S408","article-title":"Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on stillbirths and on early and late neonatal mortality","volume":"30","author":"Fall","year":"2009","journal-title":"Food Nutr Bull"},{"key":"B40","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1096\/fasebj.27.1_supplement.358.6","article-title":"Efficacy of antenatal multiple micronutrient (MM) vs iron-folic acid (ifa) supplementation in improving gestational and postnatal viability in rural Bangladesh: the JiVitA-3 Trial","volume":"27","author":"West Jr","year":"2013","journal-title":"FASEB J"},{"key":"B41","doi-asserted-by":"publisher","first-page":"S547","DOI":"10.1177\/15648265090304S409","article-title":"Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on stillbirths and on early and late neonatal mortality","volume":"30","author":"Ronsmans","year":"2010","journal-title":"Food Nutr Bull."},{"key":"B42","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3945\/ajcn.114.091546","article-title":"Lipid-based nutrient supplement increases the birth size of infants of primiparous women in Ghana","volume":"101","author":"Adu-Afarwuah","year":"2015","journal-title":"Am J Clin Nutr."},{"key":"B43","article-title":"WHO recommendation on multiple micronutrient supplementation during pregnancy","volume-title":"The WHO Reproductive Health Library.","year":"2018"},{"key":"B44","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1080\/07399332.2014.926902","article-title":"Food Beliefs and Practices During Pregnancy in Ghana: Implications for Maternal Health Interventions","volume":"9","author":"de-Graft","year":"2014","journal-title":"Health Care Women Int"},{"key":"B45","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1164\/rccm.200503-444OC","article-title":"Reduced lung function in healthy preterm infants in the first months of life","volume":"173","author":"Friedrich","year":"2006","journal-title":"Am J Respir Crit Care Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1136\/bmj.319.7217.1093","article-title":"Prediction of survival for preterm births by weight and gestational age: retrospective population based study","volume":"3197","author":"Draper","year":"1999","journal-title":"BMJ."},{"key":"B47","doi-asserted-by":"publisher","first-page":"CD002771","DOI":"10.1002\/14651858.CD002771.pub4","article-title":"Kangaroo mother care to reduce morbidity and mortality in low birthweight infants","volume":"2016","author":"Conde-Agudelo","year":"2016","journal-title":"Cochr Database Syst Rev."},{"key":"B48","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1053\/j.semperi.2010.09.005","article-title":"Preventing Preterm Birth and Neonatal Mortality: Exploring the Epidemiology, Causes, and Interventions","volume":"34","author":"Simmons","year":"2010","journal-title":"Semin Perinatol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1080\/20786204.2013.10874373","article-title":"Utility of kangaroo mother care in preterm and low birthweight infants","volume":"55","author":"Shrivastava","year":"2013","journal-title":"S Afr Family Pract."},{"key":"B50","first-page":"57","article-title":"Progress with the Implementation of Kangaroo Mother Care in Four Regions in Ghana","volume":"47","author":"Bergh","year":"2013","journal-title":"Ghana Med J."},{"key":"B51","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/1748-5908-7-75","article-title":"Translating research findings into practice \u2013 the implementation of kangaroo mother care in Ghana","volume":"7","author":"Bergh","year":"2012","journal-title":"Implement Sci."},{"key":"B52","doi-asserted-by":"publisher","first-page":"744","DOI":"10.4103\/1119-3077.158141","article-title":"Maternal risk factors for singleton preterm births and survival at the University of Nigeria Teaching Hospital, Enugu, Nigeria","volume":"18","author":"Iyoke","year":"2015","journal-title":"Niger J Clin Pract."},{"key":"B53","first-page":"153","article-title":"Perinatal mortality and associated risk factors: a case control study","volume":"22","author":"Bayou","year":"2012","journal-title":"Ethiop J Health Sci."},{"key":"B54","doi-asserted-by":"publisher","first-page":"e414","DOI":"10.1016\/S2214-109X(19)30059-2","article-title":"Reducing the global burden of preterm births","volume":"7","author":"Been","year":"2019","journal-title":"Lancet Glob Health."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000150597","article-title":"Combined effects of cigarette smoking and alcohol consumption on perinatal outcome","volume":"67","author":"Odendaal","year":"2009","journal-title":"Gynecol Obstet Invest."},{"key":"B56","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1097\/EDE.0b013e3181bbd46c","article-title":"Alcohol drinking pattern during pregnancy and risk of infant mortality","volume":"20","author":"Strandberg-Larsen","year":"2009","journal-title":"Epidemiology."},{"key":"B57","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0140-6736(14)60792-3","article-title":"Can available interventions end preventable deaths in mothers newborn babies, and stillbirths, and at what cost?","volume":"3840","author":"Bhutta","year":"2014","journal-title":"Lancet."},{"key":"B58","volume-title":"Every Newborn: An Action Plan to End Preventable Deaths.","year":"2014"},{"key":"B59","first-page":"1","volume-title":"The Global Strategy for Women's, Children's and Adolescents' Health (2016-2030).\u201d Every Woman Every Child, Italy.","year":"2016"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1111\/1471-0528.13451","article-title":"Quality of care for pregnant women and newborns\u2014the WHO vision.","volume":"122","author":"Tun\u00e7alp","year":"2015","journal-title":"BJOG"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1108744\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T07:30:50Z","timestamp":1675927850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1108744\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2023.1108744"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1108744","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]},"article-number":"1108744"}}