Factors Leading to Morbidity and Mortality in Neonates Presenting to Pak Emirates Military Hospital, Rawalpindi

Objective: To determine the frequency and association of different risk factors for morbidity and mortality in neonates. Study Design: Case-control study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi, Nov 2021 to Apr 2022. Methodology: A total of 332 patients (166 cases and 166 controls) admitted in the neonatal intensive care setting were includedin our study. Patients who were stillborn or had incomplete records were excluded. All patients were followed up till discharge or death and were documented for various risk factors. Results: The mean age of our study population was 11.52 ± 6.45 days, with 176 (53.0%) males. Risk factors such as low birthweight (2.06 [95% Cl 1.20-3.54]), multiple gestations (2.09 [95% Cl 1.87-2.35]), premature delivery (1.61 [95% Cl 1.01-2.57]),male gender (1.62 [95% Cl 1.05-2.51]) and lack of antenatal care (1.61 [95% Cl 1.01-2.57]) showed an association with mortality.Early-onset neonatal sepsis (1.78 [95% Cl 0.98-3.22]), hypoxic ischaemic encephalopathy (3.01 [95% Cl 1.55-5.82]), meconiumaspiration syndrome (2.42 [95% Cl 0.97-6.05]), congenital anomalies (4.15 [95% Cl 0.87 – 19.85]) and inborn errors of metabolism (7.26 [95% Cl 0.88-59.71]) were all associated with an increase in mortality. Conclusion: Increased risk for mortality in critically ill neonates is multifactorial and requires intervention at multiple levels to reduce mortality at all phases of gestation.