A case-control study of early neonatal deaths at the Port Moresby General Hospital to determine associated risk factors.

From June 1998 to December 1999, mothers of 150 babies who died in the early neonatal period and 150 controls whose babies did not die were studied. In multiple logistic regression analysis the following variables were positively associated with early neonatal deaths: lack of antenatal attendance, thick meconium staining of the liquor, male sex, very low birthweight and delivery at gestational age less than 34 weeks. Maternal betelnut chewing was negatively associated with neonatal deaths. When babies with birthweight below 1000 g were excluded, the following variables were associated with early neonatal deaths: unmarried status, thick meconium staining of the liquor and gestational age below 34 weeks. The negative association with betelnut chewing persisted. The main causes of early neonatal deaths were respiratory distress syndrome, septicaemia, birth asphyxia, meconium aspiration syndrome and congenital abnormalities. Avoidable factors in these deaths were associated with the patient (53%), the labour ward (28%), the antenatal clinic (9%), the postnatal ward (8%) and the special care nursery (2%).