Incidence and Predictors of Mortality From Low Birth Weight Among Neonates Admitted to Neonatal Intensive Care Units in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Background: Low birth weight (<2500 g) is a major contributor to neonatal mortality in sub-Saharan Africa, yet evidence specific to low birth weight neonates admitted to NICUs remains limited. Objective: To determine the pooled incidence and predictors of mortality among low birth weight neonates admitted to NICUs in sub-Saharan Africa. Methods: Following PRISMA guidelines, we searched major databases (2010-2024). Observational studies and randomized trials reporting mortality in NICU-admitted low birth weight neonates were included. A random-effects meta-analysis was conducted. Results: The pooled mortality incidence was 28.6% (95% CI: 27.70-29.52). Major predictors of mortality were neonatal sepsis (OR 4.15, 95% CI: 3.22-5.36), very low birth weight <1500 g (OR 3.82, 95% CI: 2.95-4.92), and respiratory distress syndrome (OR 3.09, 95% CI: 2.41-3.97). Conclusion: Mortality among NICU-admitted low birth weight neonates remains high. Strengthened infection prevention, respiratory care, and antenatal services are urgently needed.PROSPERO: CRD420251001967.