Predictors of post-anaesthetic mortality in newborns in Kinshasa (2025-2026): a prospective cohort study. Original article.

This is the authors' abstract. We don't add key points for this paper.

ntroduction Mortality in neonatal anaesthesia is low in high-income countries (<5%), but high in Africa. The studies on this topic are scarce. This study aimed to identify predictors of mortality in neonatal anaesthesia in Kinshasa. Methods A prospective cohort study conducted among 178 new- borns who underwent anaesthesia for a surgical and/or diagnostic procedure in five hospitals. Recruitment was exhaustive and consecutive. Pre, intraoperative and post- operative evolutionary variables, were recorded. Statisti- cal analyses used Chi-square test, bivariate and multivar- iate logistic regression; the threshold for statistical signif- icance was set at p < 0.05. Results Post-anaesthesia mortality was 39.9%. Significant pre- dictors were: prematurity (ORa = 4.9), birth weight ( ORa = 3.5), weight on the day of surgery < 2500 g ( ORa = 3.9), age on the day of surgery between 1–7 days (ORa = 5.7) and 8–14 days ( ORa = 9.8), American Society of Anesthesiologists (ASA)-physical status III ( ORa = 10.2; p = 0.001) and IV ( ORa = 18.7; p = 0.001), and emergency ( ORa = 3.05). General anaesthesia was pre- dominant (96.6%) and associated with mortality (p = 0.005). Standard monitoring was absent in 100% of cases. Conclusion Post-anaesthesia neonatal mortality in Kinshasa remains high. The specific predictors identified serve as a warning sign in clinical management to reduce this mortality.