Published in PLOS One on 2025-12-11, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Grace Frank Mhando, Salvatory Florence Kalabamu, Maulidi Rashidi Fataki, Christina Clinton Galabawa, Kelvin Melkizedeck Leshabari
Source: PLOS One • DOI 10.1371/journal.pone.0338497
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Newborn deaths are still a concern to global health systems. Increased rates of documented hospital-based births are incongruent to newborn survival chances worldwide. Factors for that rather paradoxical observation are largely unknown. We aimed to assess predictors of early newborn deaths at representative metropolitan referral health facilities in Africa.
We designed a prospective, analytical, hospital-based study in neonatal units at Dar es Salaam public regional referral hospitals, Tanzania. Neonates who died within the first 7 days of life were the target population. A pre-designed Case Report Form was the main tool for data collection. Multivariable binary logistic regression model was fitted to account for predictors of early newborn deaths after appropriate linear model validation. Proportion of early newborn deaths was the outcome variable.
We recruited and analysed 2212 neonate-days of follow-up. Prevalence of early newborn deaths was 28.1%. Birth asphyxia (χ2 = 20.4, df = 1), preterm delivery (χ2 = 5.36, df = 1) and respiratory distress syndrome (χ2 = 30.94, df = 1) were associated with early neonatal outcomes. Predictors of early newborn deaths were neonatal respiratory rate (Tachypnoea – A.O.R.: 2.28 (95% CI.: 1.44–5.79); Bradypnoea – A.O.R.: 1.9 (95% C.I.: 1.02–12.3) and gestational age (Preterm delivery – A.O.R.: 1.48, 95% CI.: 1.11–2.09 and Post-term delivery – A.O.R.: 5.05, 95% C.I.: 4.49–32.0).
Early newborn deaths rate was relatively high in this study population. Newborns’ respiratory rates and gestational age at delivery were significant clinical factors associated with early newborn deaths in this study.
Introduction
Early newborn (neonatal) deaths remain a major public health concern worldwide, especially in Africa [1–3]. Early newborn deaths refer to mortal events happening within the first seven days of life, and late newborn deaths are those that happen after seven days but within the first 28 days of extra-uterine life [4,5]. At present, the demographic data on neonatal death risk factors tend to be controversial. For instance, the three commonest factors associated with early neonatal deaths in developed countries are prematurity, congenital abnormalities, and low APGAR scores [6]. In contrast, regions like Africa south of Saharan desert report the greatest rate of early neonatal deaths, mainly due to neonatal infections (e.g., sepsis, pneumonia), birth asphyxia as well as complications associated with preterm delivery [7]. Dar es Salaam city is among the fastest growing cities in Africa [8]. Dar es Salaam is scheduled to be the third most populous city in Africa by 2050 [8]. The interplay for the factors associated with early neonatal deaths in developing countries (Tanzania inclusive) tend to be multifactorial and non-specific. At the very least, little is known about the dynamics and interplay of those factors early in life.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2025 Grace Frank Mhando, Salvatory Florence Kalabamu, Maulidi Rashidi Fataki, Christina Clinton Galabawa, Kelvin Melkizedeck Leshabari. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
- Evidence brief: Neonatal survival and mortality predictors among low-birth-weight neonates: A Retrospective cohort study from Suhul Hospital, northern Ethiopia
- Evidence brief: Counting missing babies in Tanzania: Neonatal mortality data quality from Tanzania’s District Health Information System across 28 Regional and 7 Tertiary hospitals (2015–2024)
