Determinants of neonatal mortality in hospitals in the Tshopo province of the Democratic Republic of Congo

Introduction Neonatal mortality is a major global public health issue, with uneven distribution across regions. Its determinants remain poorly understood in Tshopo province. Purpose This study aimed to identify the determinants of neonatal mortality in hospitals in the Tshopo province of the Democratic Republic of Congo. Methods A case-control study was conducted in the maternity wards of selected hospitals. Based on records in the children's files, deaths occurring during the first 28 days were classified as cases, and survivors were considered controls. Data were collected using a structured questionnaire administered by trained interviewers. Statistical analysis was performed using Jamovi 2.6.44. Descriptive statistics, association tests, and binary logistic regression were employed to identify determinants at a 95% confidence level. Results Binary logistic regression revealed the following determinants: insufficient tetanus vaccination (ORa = 2.1, 95% CI [1.2–3.7], p = 0.007); presence of pregnancy pathologies (ORa = 4.4, 95% CI [2.7–7.1], p < 0.001), including high blood pressure (ORa = 9.4, 95% CI [3.7–23.8], p < 0.001), gonorrhea (ORa = 4.1, 95% CI [1.6–10.1], p = 0.003), and malaria (ORa = 2.4, 95% CI [1.4–4.3], p = 0.002). Other determinants included scarred uterus (ORa = 0.4, 95% CI [0.3–0.9], p = 0.019), prematurity (ORa = 3.2, 95% CI [1.1–9.4], p = 0.033), fetal distress (ORa = 6.6, 95% CI [3.5–12.47], p < 0.001), out-of-hospital delivery (ORa = 2.2, 95% CI [1.0–4.5], p = 0.037), male newborn (ORa = 1.6, 95% CI [1.0–2.4], p = 0.042), and low birth weight (ORa = 3.8, 95% CI [2.0–7.2], p < 0.001). Conclusion This study underscores the need for concerted efforts to improve maternal and neonatal health in Tshopo province. It demonstrates that effective pre-, intra-, and postnatal monitoring can reduce neonatal mortality.