Abstract

Background: Neonatal mortality is disproportionately high in sub-Saharan African countries and most neonatal deaths result from preventable causes. The causes of neonatal deaths remain significant contributors to death after the first 28 days of life, necessitating amplification of the current public health attention.
Objective: We sought to consolidate data on the impact of neonatal conditions on death beyond the neonatal period. Additionally, we reviewed information on the continuum of acute neonatal conditions and their sequelae that should be explored to adequately address the full impact of mortality from neonatal conditions.
Methods: We searched Google Scholar, PubMed, and Cochrane databases using the key search terms “neonate”, “mortality”, “survival”, “infant”, “prematurity”, “birth asphyxia” and “neonatal infections”. The spillover of neonatal mortality was defined as mortality arising from neonatal related conditions after the first month of life.
Result: Nineteen studies that reported on causes of mortality in the neonatal period and death from neonatal conditions after the first month of life were included in this review. Prematurity (13.6%-89%) [1,2], intrapartum-related events notably birth asphyxia (3%-56.8%) [3,4], and neonatal infections (6%- 47.4%) [5,6] were the top three causes of death in the first 28 days of life. Beyond the first month of life, prematurity (1.2%-40.2%) [7,8], and birth asphyxia (2.6%- 37.5%) [7,9] still caused significant mortality.
Conclusion: Conditions diagnosed during the neonatal period result in high mortality after the first month of life. Comprehensive care packages should entail longer-term assessment, monitoring, and evaluation plans for children treated for acute conditions in the neonatal period. Additionally, healthcare systems need to be strengthened for robust treatment of acute neonatal conditions to reduce the spillover mortality from neonatal conditions.

Keywords:Neonatal mortality; Infant mortality; Prematurity; Birth asphyxia; Neonatal sepsis