Neonatal Morbidity and Mortality Pattern in a Tertiary Care Neonatal Icu of a Teaching Hospital

Background: Pakistan is ranked third among the countries having the highest annual rate of neonatal deaths. Three main factors worldwide that contribute to neonatal mortality (NNM) in low-income nations are prematurity, birth asphyxia, and sepsis. Objective: To identify the causes and patterns of newborn death in a tertiary care neonatal intensive care unit. Methodology: This retrospective analysis was carried out at the multiple centers including Jinnah Teaching Hospital Peshawar and The Children's Hospital and University of Child Health Sciences (UCHS) in the duration from Jan, 2023 to June, 2023. The research included all neonates admitted alive to the neonatal intensive care unit, along with a definitive diagnosis and supporting symptoms. Data was gathered using a pre-made proformas. A minimum of one diagnosis was assigned to each neonate based on the modified Wigglesworth classification. Results: Out of 1765 admitted sick neonates, 67.5% were male and 32.5% female. Morbidity pattern showed share of prematurity 33.6%, sepsis 30.08%, birth asphyxia 12.12%, meconium aspiration syndrome (MAS) 5.55%, congenital malformations 3.9%, Transient tachypnea of newborn (TTN) 5.21%, neonatal jaundice (NNJ) 2.94%, Intrauterine growth restriction (IUGR) 2.66%, Infant of diabetic mother (IDM) 1.5%, seizure disorder (1.5%) and bleeding diathesis 0.79%. Mortality was 19.54% (345 cases). Early neonatal mortality was 86.6%. Case fatality for prematurity was 28.78%, Birth asphyxia 21.49%, congenital malformations 26%, sepsis 16.94%, MAS 14.28%, and seizure disorder 22.22%. Conclusion: The study found that the primary causes of newborn death were prematurity, low birth weight, neonatal infection, and birth asphyxia. Healthcare managers should design and execute interventions at the community level to prevent low birth weight, premature delivery, and birth asphyxia. There will undoubtedly be fewer infant fatalities if neonatal care is improved at all levels.