Iziki H, et al. Infect Chemother. 2024 Sep;56:e41. https://doi.org/10.3947/ic.2024.0056

Perinatal asphyxia (PA) is a major health problem, responsible for high mortality and a wide range of morbidity. Several factors play a part in the occurrence of perinatal mortality during asphyxia. The aim of this work was to identify factors predictive of perinatal mortality following PA, using an unmatched case-control study. Thus, 31 cases and 126 controls were identified with a total of 157 newborns suffering from PA. It was carried out during April 1 to June 30, 2022, at the Mohammed VI University Hospital in Marrakech. The socio-demographic, clinical, and biological data of the newborns were collected using an evaluation grid. In this series, the sex ratio was 0.96 and the case-fatality rate 20%. The results showed that the factors showing a statistically significant association in the genesis of mortality in PA cases were : intrauterine growth retardation [(ORA= 4711,799), 95%, IC : ( 48,964, 453416,766)] ; maternal history [ (ORA =31,876, 95%,CI : (1,346;755,149)] ; Apgar index after 5 min less than or equal to 3: [(ORA=139,75), 95%, CI : (16,523 ; 1182,01)]; and congenital malformations : [(ORA=241,435), 95%, CI : ( 6,044 ; 9644,748)]. Consequently, addressing these factors is crucial to identify high-risk newborns at an early stage and to implement appropriate measures. The goal is to eliminate avoidable morbidity and disability.

Although COVID-19 in children is benign, it has revealed a critical vulnerability in the neonatal population. This study aimed to identify the mortality predictors and determinants of survival in children affected by COVID-19 in the Marrakech-Safi (RMS) region of Morocco. This was a retrospective, multicenter cohort study conducted among children hospitalized with COVID-19 between March 2020 and December 2021 in two RMS hospitals. All patients aged under 15 years with confirmed SARS-CoV-2 infection were included; incomplete files, misdiagnoses, and transferred patients were excluded. Overall survival was assessed using the Kaplan–Meier curve, associations were examined with the log-rank test, and predictors were identified using Cox proportional hazards regression models. A total of 167 children were identified, including 52.7% females and 20.4% (n = 34) neonates. The death rate was 4.79%, with a mean overall survival of 40.9 days. The analysis identified thrombocytopenia (adjusted hazard ratio [aHR] = 87.07, 95% confidence interval [CI]: 59.85-126.77, P <0.001), cardiopathy (aHR = 34.95, 95% CI: 3.41-358.23, P = 0.003), maternal-fetal infection (aHR = 57.65, 95% CI : 4.00-831.62, P = 0.003), and the presence of respiratory distress (aHR = 48.37, 95% CI: 3.30-709.01, P = 0.005) as major mortality predictors. Implementing rapid intervention and preventive medicine strategies is essential to reducing morbidity and mortality in pediatric populations during future public health emergencies.

Background: Neonatal mortality (NNM) has significantly decreased in developed countries. However, it remains a major public health issue and a particular challenge in developing countries, with Morocco being no exception, as its NNM rate remains high. Objectives: This study aims to identify factors associated with NNM within the Neonatology Department at the Regional Hospital Center of Agadir. Methods: An analytical cross-sectional study design was chosen. To determine factors associated with early NNM, we employed binary logistic regression in both univariate and multivariate analyses, including all statistically significant variables in the multivariate model. Results: Three hundred and eight deceased neonates were included. The intra-hospital NNM rate was 17.4%, 95% CI (13.2 - 21.7), during the period from 2018 to 2021. A predominance of early NNM (81.8%). 52.3% were females. 47.7% of the deceased had low birth weight. 65.9% of the cases had an Apgar score < 7. 44.2% were resuscitated. The factors that were statistically associated with the risk of early NNM were as follows: Admission age ≤ 1 day (aOR: 17.87; 95% CI: 5.78 - 55.29), neonatal admission age 2 - 7 days (aOR: 6.64; 95% CI: 1.68 - 26.30). Intra-hospital referral (aOR: 4.49; 95% CI: 1.59 - 12.65); emergency consultations (aOR: 4.25; 95% CI: 1.28 - 14.01). Conclusions: Neonatal mortality remains a major public health challenge in Morocco. Different risk factors associated with NNM have been identified. Addressing these factors could reduce neonatal deaths in low-resource countries. For this reason, we need to intensify our efforts to develop reliable and precise approaches.