Neonatal Tetanus in Southern Iran: Predisposing and Prognostic Factors

Background: The predisposing and prognostic factors for neonatal tetanus (NNT) have not been adequately studied in southernIran. Objective: The present study was undertaken in Fars Province to further clarify the status of neonatal tetanus in this region. Methods: The mortality rate was correlated with demographic and clinical findings in 112 cases of neonatal tetanus.  In addition, the height and weight of NNT patients were compared to those of 112 age- and sex-matched normal neonates. Results: Patients were predominantly males (82%) with a male to female ratio of 4.8:1.  Although the clinical presentation and outcome of male and female patients were very similar, both groups had a significantly (p<0.05) lower birth weight compared to their control counterparts.  None of the mothers had been immunized against tetanus and 92% had delivered at home under unsterile conditions.  The mortality rate was 44% and strongly related to the age of the patients on admission. Conclusions: Male sex, low birth weight, and a lack of immunization of mother, all predispose the newborn to tetanus.  The mortality rate was inversely proportional to the age of the newborn.