Trends in Neonatal Mortality Rate in Ibn-Atheer Teaching Hospital, Mosul - Northern Iraq (2020-2024)
DOI:
https://doi.org/10.64554/nujms.2026.2.1.2Abstract
Background: Neonatal mortality (NM), defined as the death of a live-born infant within the first 28 completed days of life, regardless of gestational age, is considered a key international indicator reflecting the quality and accessibility of a country's health care
services.
Objective: This study aims to analyze trends in neonatal mortality and identify the leading causes of death in Ibn Al-Atheer Teaching Hospital during the period 2020–2024.
Method: A retrospective descriptive study was conducted using existing data on neonatal deaths over a five-year period starting from 2020, obtained from the Statistical Department at Ibn Al- Atheer Teaching Hospital. The study included all neonates admitted to the hospital from January 1st to December 31st of each year within the study period.
Result: The trend of neonatal mortality rates at Ibn Al-Atheer Teaching Hospital throughout the study period (2020 – 2024) shows a notable decline, indicating an improvement in neonatal outcomes during this period. The most common cause of neonatal mortality throughout the study period was Bacterial Sepsis, which accounted for the highest proportion of deaths in most of the years observed. Other significant causes included Respiratory distress of the newborn and Causes related to chromosomal and congenital
abnormalities.
Conclusion: The neonatal mortality patterns observed in our study have declined over time but face persistent challenges from sepsis, respiratory distress syndrome (RDS), prematurity, and birth complications.
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References
1. Dimitrova A, Dimitrova A, Mengel M, Gasparrini A, Lotze-Campen H, Gabrysch S.
Temperature-related neonatal deaths attributable to climate change in 29 low-and
middleincome countries. Nature communications. 2024 Jun 29;15(1):5504.
https://doi: 10.1038/s41467-024-49890-x.
2. Gunawardane DA. Sri Lankan Newborns; Improving Survival and Well-Being. Sri
Lanka Journal of Medicine. 2024 Apr 5;33(1). https://doi: 10.4038/sljm.v33i1.497.
3. World Health Organization, the global health observatory2022, Explore a world of
health data. Neonatal mortality rate (0 to 27 days) per 1000 live births) (SDG 3.2.2)
4. Odejimi A, Quinley J, Eluwa GI, Kunnuji M, Wammanda RD, Weiss W, James F,
Bello M, Ogunlewe A, King R, Franca-Koh AC. Causes of deaths in neonates and
children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and
Social Autopsy study. BMC Public Health. 2022 Jun 6;22(1):1130. https://doi:
10.1186/s12889-022-13507-z.
5. Park K. Park text book of preventive and social medicine. 23rd Ed. Banarsidas Bhanot
publishers. India, 2015.
6. UNICEF U. UN inter-agency group for child mortality estimation. Levels and trends
in child mortality. 2015 Sep 9.
7. Ogbuoji O, Yamey G. How many child deaths can be averted in Nigeria? Assessing
statelevel prospects of achieving 2030 sustainable development goals for neonatal and
under-five mortality. Gates Open Research. 2019 May 9;3:1460. https://doi:
10.12688/gatesopenres.12928.1.
8. Rosa-Mangeret F, Benski AC, Golaz A, Zala PZ, Kyokan M, Wagner N, Muhe LM,
Pfister RE. 2.5 million annual deaths—are neonates in low-and middle-income
countries too small to be seen? A bottom-up overview on neonatal morbi-mortality.
Tropical medicine and infectious disease. 2022 Apr 21;7(5):64. Page 11 of 13 - AI
Writing Submission Submission ID trn:oid:::1:3481280164 https://doi:
10.3390/tropicalmed7050064.
9. Hossain SM, Chou VB, Ibrahim S, Alhilfi R, Lami F, Sarnak D, Khanam R, Al-Dahir
S, Burnham GM, Baqui AH, Ahmed S. Child Mortality and Maternal, Neonatal and
Child Health in Iraq in the Last Two Decades: Trends and a Way Toward the SDG
Targets for Child Survival. https://doi: 10.2139/ssrn.3797585.
10. Ali M, Blacker J, Jones G. Annual mortality rates and excess deaths of children under
five in Iraq, 1991-98. Population studies. 2003 Jan 1;57(2):217-26. https://doi:
10.1080/0032472032000097119.
11. Cetorelli V. The impact of the Iraq War on neonatal polio immunisation coverage: a
quasiexperimental study. J Epidemiol Community Health. 2015 Mar 1;69(3):226-31.
https://doi: 10.1136/jech-2013-203174.
12. Mortality before and after the 2003 invasion of Iraq: cluster sample survey, Roberts,
Les et al. The Lancet, Volume 364, Issue 9448, 1857 – 1864 https://doi:
10.1016/S0140-6736(04)17441-2.
13. Burnham G, Lafta R, Doocy S, Roberts L. Mortality after the 2003 invasion of Iraq: a
crosssectional cluster sample survey. Lancet 2006; 368(9545): 1421-8. https://doi:
10.1016/S0140-6736(06)69491-9.
14. Ibrahim S, Al-Dahir S, Al Mulla T, Lami F, Hossain SM, Baqui A, Burnham G.
Resilience of health systems in conflict affected governorates of Iraq, 2014–2018.
Conflict and Health. 2021 Dec;15:1-9. https://doi: 10.1186/s13031-021-00412-2.
15. Abdulrasol ZA, Obaid AF, Kadim MA, Shlash AM. Mortality rate among Iraqi
neonates in neonatal intensive care units: Retrospective study. Journal of Neonatal
Nursing. 2024 Apr 1;30(2):148-51. https://doi: 10.1016/j.jnn.2023.07.018.
16. Nayyef, Nadia Kadhim; Al-Bairmani, Jawad Kadhim; Al-Hillali, Ayser Mohammed.
Perinatal and Neonatal Mortality, Risk Factors, and Causes in Babylon Teaching
Hospital for Maternity and Children During 2018. Medical Journal of Babylon 17(1):p
58-63, Jan– Mar 2020. | https://doi: 10.4103/MJBL.MJBL_93_19.
17. Abd AM. Assist. Lec. Ali Fadhil Obaid (Doctoral dissertation, University of Babylon).
18. Medeiros P, Bailey C, Andrews C, Liley H, Pollock D, Gordon A, Flenady V.
Effectiveness of neonatal “near miss” audits in reducing perinatal morbidity and
mortality: a systematic review protocol. JBI evidence synthesis. 2022 Mar 1;20(3):847-
53 https://doi: 10.11124/JBIES-21-00069.
19. Oza S, Lawn JE, Hogan DR, Mathers C, Cousens S. Cause-of-death estimates for the
early and late neonatal periods for 194 countries from 2000-2013. arXiv preprint
arXiv:1411.4021. 2014 Nov 14.
20. Klein SL. Hormones and the mating system affect sex and species differences in
immune function among vertebrates. Behav Processes. 2000;51:149–66.
21. Chowdhury R, Taneja S, Mazumder S, Bhandari N, Strand TA. Gender differences in
infant survival: a secondary data analysis in rural North India. BMJ Open.
2017;7:e014179.
22. Greenwell F. MDG 4-5: Reduce child mortality and improve maternal health.
23. Green C, Walker AS, Sharland M, et al. Global burden of neonatal sepsis: A multicenter
observational study. UCL News [Internet]. 2023 Jun [cited 2025 Aug 18].Available
from:https://www.ucl.ac.uk/news/2023/jun/global-study-highlights-deaths-newbornbabiessepsis.
24. Semahegn A, Gebreslassie A, Tadesse Y, et al. Trends in neonatal mortality and
associated factors in low-income countries: A systematic review. BMC Public Health.
2022;22(1):1223. Available from:
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022- 12765-1
25. Ou Z, Yu D, Liang Y, He H, He W, Li Y, Zhang M, Gao Y, Wu F, Chen Q. Global trends
in incidence and death of neonatal disorders and their specific causes in 204
countries/territories during 1990–2019. BMC Public Health. 2022 Feb 19;22(1):360.
https://doi: 10.1186/s12889-022-12765-1.
26. Stock SJ, Thomson AJ, Papworth S. Antenatal corticosteroids to reduce neonatal
morbidity and mortality. Green‐top Guideline No. 74. BJOG: An International Journal
of Obstetrics & Gynaecology. 2022 Jul 1;129(8). https://doi:10.1111/1471-0528.17027.
27. Berger DS, Garg B, Penfield CA, Caughey AB. Respiratory distress syndrome is
associated with increased morbidity and mortality in late preterm births. American
Journal of Obstetrics & Gynecology MFM. 2024 Jun 1;6(6):101374. https://doi:
10.1016/j.ajogmf.2024.101374.
28. Al-Fathy MY, Ameen HF, Al-Fathi MY, Alsabea WM, Al-Rawee RY, Hussein AA,
Mustafa IM, Mustafa IJ, Abul-Rahman AK. Top ten causes of mortality among children
under five in Nineveh 2018-2023: a time series analysis.
29. Abdulrasol ZA, Obaid AF, Kadim MA, Shlash AM. Mortality rate among Iraqi neonates
in neonatal intensive care units: Retrospective study. Journal of Neonatal Nursing. 2024
Apr 1;30(2):148-51. https://doi: 10.1016/j.jnn.2023.07.018.
30. World Health Organization. Newborn Mortality [Internet]. WHO; 2022 [cited 2025 Aug
18]. Available from: https://www.who.int/news-room/fact-sheets/detail/newbornmortality.
31. Gates Foundation. 2023 Goalkeepers Report: Progress on Maternal and Neonatal
Health [Internet]. 2023 [cited 2025 Aug 18]. Available
from:https://time.com/6312835/maternalmortality- gates-foundation-2023-report.
32. Hossain SM, Chou VB, Ibrahim S, Alhilfi R, Lami F, Sarnak D, Khanam R, Al-Dahir
S, Burnham GM, Baqui AH, Ahmed S. Child Mortality and Maternal, Neonatal and
Child Health in Iraq in the Last Two Decades: Trends and a Way Toward the SDG
Targets for Child Survival.
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