Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 19;10(6):e0130712.
doi: 10.1371/journal.pone.0130712. eCollection 2015.

High Incidence of Neonatal Danger Signs and Its Implications for Postnatal Care in Ghana: A Cross-Sectional Study

Sumiyo Okawa  1 , Evelyn Korkor Ansah  2 , Keiko Nanishi  1 , Yeetey Enuameh  3 , Akira Shibanuma  1 , Kimiyo Kikuchi  1 , Junko Yasuoka  1 , Margaret Gyapong  4 , Seth Owusu-Agyei  3 , Abraham Rexford Oduro  5 , Gloria Quansah Asare  6 , Abraham Hodgson  2 , Masamine Jimba  1 ; Ghana EMBRACE Implementation Research Project Team
Collaborators, Affiliations

High Incidence of Neonatal Danger Signs and Its Implications for Postnatal Care in Ghana: A Cross-Sectional Study

Sumiyo Okawa et al. PLoS One. .

Abstract

Background: Reducing neonatal mortality is a major public health priority in sub-Saharan Africa. Numerous studies have examined the determinants of neonatal mortality, but few have explored neonatal danger signs which potentially cause morbidity. This study assessed danger signs observed in neonates at birth, determined the correlations of multiple danger signs and complications between neonates and their mothers, and identified factors associated with neonatal danger signs.

Methods: A cross-sectional study was conducted in three sites across Ghana between July and September in 2013. Using two-stage random sampling, we recruited 1,500 pairs of neonates and their mothers who had given birth within the preceding two years. We collected data on their socio-demographic characteristics, utilization of maternal and neonatal health services, and experiences with neonatal danger signs and maternal complications. We calculated the correlations of multiple danger signs and complications between neonates and their mothers, and performed multiple logistic regression analysis to identify factors associated with neonatal danger signs.

Results: More than 25% of the neonates were born with danger signs. At-birth danger signs in neonates were correlated with maternal delivery complications (r = 0.20, p < 0.001), and neonatal complications within the first six weeks of life (r = 0.19, p < 0.001). However, only 29.1% of neonates with danger signs received postnatal care in the first two days, and 52.4% at two weeks of life. In addition to maternal complications during delivery, maternal age less than 20 years, maternal education level lower than secondary school, and fewer than four antenatal care visits significantly predicted neonatal danger signs.

Conclusions: Over a quarter of neonates are born with danger signs. Maternal factors can be used to predict neonatal health condition at birth. Management of maternal health and close medical attention to high-risk neonates are crucial to reduce neonatal morbidity in Ghana.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. UNICEF. Committing to child survival: a promise renewed. New York: UNICEF; 2014. 10.1186/1742-4755-11-82 - DOI
    1. Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14:521 10.1186/1471-2458-14-521 - DOI - PMC - PubMed
    1. Engmann C, Walega P, Aborigo RA, Adongo P, Moyer CA, Lavasani L, et al. Stillbirths and early neonatal mortality in rural Northern Ghana. Trop Med Int Health. 2012;17(3):272–82. 10.1111/j.1365-3156.2011.02931.x - DOI - PubMed
    1. Kozuki N, Lee AC, Silveira MF, Victora CG, Adair L, Humphrey J, et al. The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 2013;13 Suppl 3:S3 10.1186/1471-2458-13-S3-S3 - DOI - PMC - PubMed
    1. Welaga P, Moyer CA, Aborigo R, Adongo P, Williams J, Hodgson A, et al. Why are babies dying in the first month after birth? A 7-year study of neonatal mortality in northern Ghana. PLOS One. 2013;8(3):e58924 10.1371/journal.pone.0058924 - DOI - PMC - PubMed

Publication types

MeSH terms