Common Causes and Risk Factors for Neonatal Death

The two leading causes of neonatal death (infant death occurring with the first 28 days of life) are due to prematurity/low birth weight and birth defects.

Prematurity/Low Birth Weight:

Premature birth is defined as occurring before 37 weeks gestation and account for approximately 70% of low birth weight cases. Low birth weight is also a complication due to fetal growth restriction (IUGR) which accounts for the remaining 30% of low birth weight cases.

Risk Factors for Prematurity Include:

  • previous premature birth
  • certain abnormalities of the uterus or cervix
  • multiples (twins, triples +)

Medical Conditions which may increase risk:

  • diabetes
  • clotting disorders
  • being under weight or obese during pregnancy
  • high blood pressure
  • maternal infections

Lifestyle Factors which may increase risk:

  • smoking, drinking alcohol, recreational drug use and pharmaceutical medication not recommended for use in pregnancy
  • late or no prenatal care
  • extreme stress or stressful working conditions

Complications due to prematurity:
The four most common complications due to prematurity of the baby which can lead to neonatal death include:

Respiratory distress syndrome – a result of immature lungs which lack a protein called surfacant that keeps the lungs from collapsing

Intraventricular hemorrhage – bleeding in the brain which can result in brain damage or death

Necrotizing enterocolitis – a serious intestinal problem causing inflammation of the bowel

Infections – including pneumonia, sepsis and meningitis

Birth Defects:

The four main causes of neonatal death due to birth defects can occur with a premature or full term baby and include:

Lung defects – a baby can have a malformation or be underdeveloped in one or both lungs. Many times babies who die due to lung defects are related to their premature birth. Other causes include pregnancy complications (low amniotic fluid) and other birth defects.

Heart defects – the most common cause of birth defect-related neonatal death. Many babies who die of birth defect related heart defects in the first month have a defect called hypolastic left heart syndrome.

Chromosomal abnormalities – many cases of chromosomal abnormalities result in miscarriage but in some cases the baby survives until birth but will die in the early weeks of life.

Central nervous system and brain abnormalities – several CNS/brain related birth defects can be a cause for neonatal death. Depending on the particular defect the baby may die within the first few hours or first few weeks.

Other Causes of Neonatal Death:

  • complications with the placenta, umbilical cord or membranes
  • SIDS
  • lack of oxygen before or during birth
  • infections (including GBS)


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