Impact of maternal and neonatal factors on mortality in the first six weeks of life: A comprehensive cohort study in Kinshasa, DR Congo

Preventable maternal and neonatal factors of early and late neonatal mortality in rural city of Tshumbe, Sankuru Province, Democratic Republic of the Congo.

Beyond 42 Days: A National Cohort Study of Maternal and Late Maternal Deaths in Brazil from 2010 to 2023

Maternal mortality is a serious public health problem and reflects social, ethnic, racial, and regional inequalities in access to and quality of obstetric care. Despite advances in the surveillance and investigation of maternal deaths in Brazil, late maternal deaths (occurring between 43 days and 1 year after birth) are still underestimated and underexplored. Therefore, the objective of this study was to analyze the distribution and factors associated with maternal deaths and late maternal deaths in Brazil between 2010 and 2023. This was a population-based, retrospective cohort study with a quantitative approach, using secondary data from the Mortality Information System. All maternal deaths (Chapter XV of ICD-10) and late deaths recorded during the period were included. Sociodemographic, clinical, and administrative variables were analyzed. Statistical tests of association (chi-square, test of proportions, and 95% CI) were used, with a significance level of 5%. A total of 26,953 deaths were identified, of which 24,387 were maternal and 2566 were late deaths. Most deaths occurred among single, mixed-race women with 8 to 11 years of schooling, and residing in the Southeast region. Late deaths were more frequent in the South and among women aged 40 to 49. The main causes were direct obstetric conditions. A statistically significant association was observed between the type of death and sociodemographic variables. The results highlight structural inequalities in maternal mortality in Brazil and reinforce the importance of expanding postpartum surveillance beyond 42 days, with a focus on equity and continuity of care.

Patterns and determinants of child mortality in India: a multistate analysis using National Family Health Survey data

Background: This paper, utilizing data from several rounds of the National Family Health Survey, investigated long-term differentials in child mortality rates across caste groups and seeked to identify the principal determinants of child survival. Methods: Trends in child mortality rates were analyzed by using all five rounds of NFHS. Survival analysis and regression analysis were performed by using NFHS-5 (2019-2021). The study included children aged 1-59 months born in the five years preceding the survey, excluding infant deaths. Kaplan-Meier survival analysis, log-rank tests, and binary logistic regression models were used, taking into account the survey design. State-level analysis was performed for Uttar Pradesh, Madhya Pradesh, and Maharashtra. Results: At the national level, the rate of child mortality was highest among Scheduled Tribes (9.03 per 1,000), followed by Scheduled Castes (8.58 per 1,000), compared with non-SC/ST children (6.04 per 1,000). The survival analysis revealed significant caste differentials in child survival (χ2=28.47, p<0.001), with the gap increasing at older ages of childhood. In unadjusted regression models, Scheduled Castes (OR=1.38; 95% CI: 1.16-1.65) and Scheduled Tribes (OR=1.56; 95% CI: 1.32-1.85) had significantly higher odds of child mortality. These associations were reduced and rendered non-significant after adjusting for proximate determinants, indicating mediation by maternal and health-related variables. Maternal education had a strong protective effect, with higher education being associated with significantly lower odds of child mortality (OR=0.27). Conclusions: Although there has been a steady decline in child mortality rates across NFHS cycles, caste and geographic inequities in India.

Coverage and factors associated with receipt of early newborn postnatal care components in Afghanistan: findings from the 2022–2023 multiple indicator cluster survey

ABSTRACT Background Neonatal mortality remains high in low‑ and middle‑income countries, where early postnatal care (PNC) within 48 hours can avert many deaths. Yet neither the national coverage of newborn PNC nor the factors associated with its receipt have been assessed. Objectives We assessed the coverage of newborn PNC components and the factors associated with their receipt in Afghanistan. Methods We conducted a cross‑sectional analysis of 11,965 mother–infant dyads from the 2022–2023 Afghanistan Multiple Indicator Cluster Survey. The outcome was coded ‘yes’ if the infant received at least two of the following six newborn PNC components within 2 days of birth: temperature measurement, weighing, cord examination, breastfeeding counseling, observation of breastfeeding, and counseling on danger signs. We fitted a multivariable logistic regression model to identify factors associated with the outcome. Results Only 41.0% of infants received ≥2 components; merely 1.9% received all six components of PNC. The odds of receiving ≥2 components of PNC were higher among infants whose households had an educated head, whose mothers attended 1–3 or ≥4 antenatal care (ANC) visits, those born in private and public health facilities, and those delivered by cesarean section. Infants in higher wealth quintiles also had progressively greater odds. Conversely, infants perceived as small at birth had lower odds of receiving ≥2 PNC components. Conclusion Four out of ten newborns received ≥2 components of PNC, with marked inequities by head of household education, ANC use, delivery setting, and wealth status. Targeted interventions addressing these inequalities are urgently needed to strengthen early newborn PNC.

MORTALITY AND ASSOCIATED FACTORS AMONG PEOPLE LIVING WITH HIV NEWLY INITIATED INTO CARE AT BAMENDA REGIONAL HOSPITAL: A RETROSPECTIVE COHORT STUDY

Mortality among PLHIV in this study was associated with advanced disease, opportunistic diseases, commorbidities and abnormal laboratory findings, and Strengthening early diagnosis, management of opportunistic infections, and monitoring of clinical and laboratory indicators may help reduce mortality in this population.

Factors associated with neonatal mortality at the Kinshasa University Hospital: a retrospective analytical cohort study

Context and objective. Neonatal mortality remains a major public health issue, particularly in sub-Saharan Africa. The present study aimed to identify factors associated with neonatal mortality. Methods. This was a retrospective analytical cohort study conducted from january 1, 2024 to october 31, 2025 in the neonatal unit, at the Kinshasa University Hospital. All hospitalized neonates with documented outcomes were included. Cox regression was used to identify factors associated with mortality, and survival was analysed using the Kaplan-Meier method. Results. A total of 1359 neonates were included, with 441 deaths, corresponding to an in-hospital neonatal mortality rate of 32.4%. Most deaths occurred early with a median survival of 17 days. Factors independently associated with mortality were: vaginal delivery (aHR=1.30 ; 95%CI :1.03-1.63), referral from facilities outside the Elonga perinatal network (aHR=1.37 ; 95%CI : 1.08-1.73), older age at admission (aHR=1.05 ; 95%CI : 1.04-1.07), resuscitation at birth (aHR=1.33 ; 95%CI : 1.07-1.66), hypothermia (aHR=1.54 ; 95%CI : 1.10-2.66), congenital malformations (aHR=1.86 ; 95%CI : 1.43-2.43) and perinatal asphyxia (aHR=1.64 ; 95%CI : 1.20-2.25). Conversely, gestational age ≥37 weeks and birth weight ≥2500g were protective. No statistically significant association was found between neonatal mortality and referral from facilities belonging to the Elonga perinatal network. Conclusion.  Neonatal mortality remains high and is mainly associated with neonatal severity factors and health system-related factors, particularly referral conditions. Strengthening perinatal care, immediate newborn management, and the referral system is essential to reduceneonatalmortality. Received January 11, 2026 Accepted April 22, 2026 https://dx.doi.org/10.4314/aamed.v19i3.3