Pattern of Neonatal Admissions & its outcome in a tertiary care hospital of Southern Punjab (a 5 years study)

Type Journal Article - Pakistan Journal of Medical and Health Sciences
Title Pattern of Neonatal Admissions & its outcome in a tertiary care hospital of Southern Punjab (a 5 years study)
Author(s)
Volume 8
Issue 4
Publication (Day/Month/Year) 2014
Page numbers 916-921
URL http://www.pjmhsonline.com/2014/oct_dec/pdf/916 Pattern of Neonatal Admissions & its outcome in a​tertiary care hospital of Southern Punjab.pdf
Abstract
Aim: To determine the disease pattern and its outcome in a neonatal unit of S. Z. H., Rahim Yar Khan.
Study design: Retrospective study.
Place & Duration of Study: The study was conducted in the neonatal unit of Sheikh Zayed Hospital,
Rahim Yar Khan from 1st January 2009 to 31st December 2013 (5 years).
Method: The data of all the admitted neonates was analyzed regarding age at admission, sex,
gestational age, birth weight, mode and place of delivery, diagnosis, and outcome (discharge,
discharge on request, left against medical advice, death) and deaths were analyzed in a same way.
Results: A total of 76800 patients (aged 0-14 years) were admitted in pediatric unit in 5 years, out of
them 20230 (26.3%) were neonates. Among the admitted neonates, male to female ratio was 1.7:1.
Low birth weight accounted for 53% of total admissions. Major causes of admission were birth asphyxia
36.6%, prematurity with complications 34%, sepsis 14.6%, congenital malformations 5.6% and
neonatal jaundice 4.1%. Neonates admitted aged less than 24hours were 56% and 64% of neonates
were delivered by spontaneous vaginal delivery while 36% cesarean born. Neonates delivered in SZH
were 41% followed by private hospitals 34% and home 22%. Out of the total neonatal admissions, 67%
were discharged in a satisfactory condition, 3.9%were discharged on request, 3.3% left against
medical advice and 25.8% expired. Out of the total neonatal deaths, male to female ratio was 2:1. Main
bulk of mortality was observed in first 7 days of life in 88% and 61% of the expired neonates were low
birth weight. The major causes of mortality were birth asphyxia 46% followed by prematurity with
complications 29%, sepsis 18%, meconium aspiration syndrome 2.1% and congenital malformation
2%.Of the total expired neonates, 39% were delivered at home followed by 36% in sheikh Zayed
hospital while 25% in private clinics and hospitals.
Conclusion: Birth asphyxia, low birth weight, prematurity, sepsis, and congenital malformation are the
main causes of neonatal admission and mortality. Improving antenatal services, neonatal care and
timely referral to tertiary care hospitals will definitely help to reduce neonatal morbidity and mortality.

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