Keywords
At-risk families
Tshopo Province
Obstetric determinants
Predictive risk score
Community prevention
How to Cite
Abstract
Introduction
Neonatal mortality remains a critical global public health challenge. The Democratic Republic of the Congo (DRC) continues to report high neonatal mortality rates, exceeding 26 deaths per 1,000 live births.
Purpose
This study aimed to identify family profiles at high risk of neonatal mortality in Tshopo Province, DRC, by evaluating associated maternal, obstetric, and neonatal risk factors to establish a predictive risk score.
Methods
A case-control study with nested prospective follow-up was conducted between January 2022 and July 2024 among live births across health facilities in Tshopo Province (N=690; n=230 cases, n=460 controls). Multivariable logistic regression was performed to identify independent risk factors and calculate adjusted odds ratios (aOR). Significant predictors were incorporated into a cumulative risk score to stratify family risk profiles.
Results
High-risk family profiles for neonatal mortality were characterized by lack of antenatal care attendance (aOR=5.39, 95% CI [1.92,15.19], p=.001), maternal pathologies during pregnancy (aOR=8.23, 95% CI [5.51,12.30], p<.001), operative delivery (aOR=3.60, 95% CI [1.90,6.81], p<.001), a 5-minute APGAR score <7 (aOR=1.54, 95% CI [1.01,2.35], p=.043), and low birth weight (aOR=3.83, 95% CI [2.16,6.80], p<.001). A cumulative score of ≥2 risk factors was associated with an eightfold increase in neonatal mortality risk compared to low-risk families.
Conclusion
Neonatal mortality in Tshopo Province is driven by interrelated maternal, obstetric, and neonatal factors. Routine community-based screening utilizing the five-factor risk score by community health workers can facilitate early identification, rapid referral, and targeted preventive interventions.
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Copyright (c) 2026 Ramazani, J. T., Ramazani, B. B., Masengo, C. A, Mulongo, E. K., Ngbolua, K. N., Mawunu, M., Baholy, R. R., Mbungu, R. M., Tshimungu, F. K.