Magnitude of Adverse Birth Outcomes and Predictors Among Newborns Delivered at Public Hospitals in Benadir Region, Somalia

Adverse birth outcomes remain a major public health concern, particularly in low-income countries like Somalia, which has a high neonatal mortality rate. However, data on adverse birth outcomes in the Benadir region is limited. This study assessed the magnitude and predictors of adverse birth outcomes in public hospitals in Benadir region, Somalia. An institutional cross-sectional study was conducted at Benadir and SOS Mother and Child Hospitals from November 25-2024 to January 25-2025. A systematic sampling technique was used to select 420 postpartum women. Data were collected via structured questionnaire and medical record reviews. Multivariable logistic regression was used to identify associated factors. Among the 420 postpartum women included in this study, the magnitude of adverse birth outcomes was 33.1%. Birth asphyxia (15.5%) was the most common, followed by low birth weight (8.8%), stillbirth (8.6%), preterm birth (3.8%), early neonatal death (3.8%), and congenital anomalies (2.4%). Multiple pregnancies (AOR = 4.01, 95% CI: 1.89–8.51), short birth intervals (AOR = 2.63, 95% CI: 1.27–5.47), previous bad obstetric history (AOR = 3.19, 95% CI: 1.59–6.41), ANC follow up (AOR = 5.04, 95% CI: 2.67–9.54), and pregnancy complications were significantly associated with adverse birth outcomes. Adverse birth outcomes remain highly prevalent in Benadir, with a magnitude comparable to findings reported from other low-income and conflict-affected settings in Sub-Saharan Africa. strengthening focused antenatal care, improving family planning for birth spacing, enhancing referral systems, prioritizing high-risk pregnancy follow-up, and capacity building for maternal and neonatal healthcare providers.