[Risk factors for neonatal mortality. The pediatric surgery service, Aristide Le Dantec University Hospital, Dakar].

OBJECTIVES: To determine neonatal mortality factors at the paediatric surgeon service in Aristide Le Dantec University Hospital in Dakar.

PATIENTS AND METHODS: It is a retrospective study of 245 cases collected between January 1997 and December 2006 at the paediatric surgeon service, the surgery emergency and intensive care unit of Aristide Le Dantec University Hospital. We studied the age, sex, geographical origins, consultation time, weight at birth, evacuation means to the reference medical structure, consultation motives, clinical diagnosis, associated malformations, treatment methods, surgery follow ups and death causes.

RESULTS: The neonatal death rate at the paediatric surgery service was 36.7 %. Our patients' average age was eight days. A masculine predominance was observed with a 1.57 sex ratio. The average admission time was 08 days. Sixty-five per cent (65%) of our patients came from suburbs. Thirty-eight per cent were transported by an ambulance from a health centre. Fifty-three per cent (53%) weighed less than 2,500 grams at birth. The occlusive syndrome was the commonest reason for consultation (38.5 %). The most frequently observed pathology was the ano-rectal malformations. Associated malformations were observed in 12% of the cases. The majority of the patients (52%) died before the surgical operation after an average duration of 5 days. The commonest causes of death are the digestive malformations (66%).

CONCLUSION: Male newborn babies, aged less than 8 days are the most vulnerable age group. The lack of hospital transportation means, the weak weight at birth, the caring time and the digestive pathologies are other factors of wrong diagnosis. A multidisciplinary collaboration, the improvement of the technical capacity and of the available emergency therapeutic means and the creation of an intensive paediatric care unit would certainly contribute to lower the mortality rate.