Risk factors for neonatal mortality in Neonatal Intensive Care Units (NICUs): a systematic literature review and comparison with scoring systems

Abstract

Objective: To identify neonatal death risk factors in NICUs and compare these factors with current scoring systems. Data source: This review was conducted using Web of Science, PubMed/Medline, Scopus, and Cochrane library databases, considering papers published between 2007 and 2018. Study selection: Studies conducted on the neonatal mortality risk factors in NICUs were included. We identified 3,642 unique citations; 69 full-text articles were included in the final review. Data extraction: Data elements such as the first author, published year, country, purpose, data collection period, study design, sample size, and risk factors were extracted. Data synthesis: Ninety factors were identified in three categories: 25 maternal factors, 59 neonatal factors, and six organizational factors. In total, delivery mode, non-use of steroid or corticosteroid, birth weight, gestational age, Apgar score, hospital/NICU level, and outborn status are the most cited risk factors for neonatal death. Well-known scoring systems did not consider many of the identified factors. Conclusions: Determination of risk factors in neonatal death can help neonatologists identify sick neonates who are more likely to die in NICUs and provide on-time care at their bedsides. Researchers interested in developing predictive neonatal mortality models may also use the results of this study to develop models for predicting neonatal death.

Keywords

• mortality
• death
• neonate
• neonatal mortality
• risk factors
• neonatal intensive care unit