Factors affecting the survival of the "at risk" newborn at Korle Bu Teaching Hospital, Accra, Ghana.

High risk pregnancies continue to be associated with high perinatal mortality and morbidity in developing countries. Korle Bu Teaching Hospital is no exception with a perinatal mortality rate of 98.7/1000 births. Multiple factors resulting in this include the high risk nature of the pregnancies resulting in increased incidence of premature deliveries and asphyxiated babies, the delay in transfer of the sick neonate as well as the inadequate mode of transfer. The type of delivery other than the spontaneous vaginal route also affects the outcome, though the relationship was not statistically significant. Logistic regression analysis showed that maturity, birthweight and time from birth to admission to NICU were the most significant factors associated with the survival of the neonate. Proper foetal surveillance both in the antenatal period and during labour cannot be over emphasized and the mere presence of a paediatrician at these high risk deliveries may make a difference. Also, increased vigilance in the special care offered will help reduce mortality.