Sabir Khan, Syed Imad Ali Shah, Syed Kaleem-ur Rehman, Hamid Iqbal.
Frequency, Causes and Outcome of Admissions to Neonatal Unit of a Tertiary Care Hospital.
Pak Paed J Jan ;43(1):47-52.

Objectives: The aim of this study was to determine the frequency, causes and outcome of neonatal patients admitted to special care baby unit, Khyber Teaching Hospital (KTH), Peshawar KPK from 1st January to 31st December, 2017. Methodology: It was a cross sectional study. Data of all the hospitalized neonatal patients was recorded including age, sex, and weight at the time of admission, cause of admission, length of stay in the hospital and outcome was evaluated. We also recorded their source of referral. Results: During the year 2017, a total of 5797 neonatal patients were hospitalized in special care baby unit KTH. Out of these, 4104(70.80%) were male and 1693 (29.20%) were female. Majority of neonatal patients were hospitalized during the 1st 24 hours of life. 3128 (53.95%) babies were born in KTH while 2669 (46.04%) were referred from private hospitals/maternity homes and home deliveries. Premature babies accounted for 1723 (29.72%) and 4074 (70.27%) were full term. Neonatal infections were the commonest cause of admission reaching 2384 (41.12%) [Which included sepsis 1994 (34.39%), pneumonia 341 (5.8%) and meningitis 49(0.84%) respectively] followed by neonatal jaundice 1502 (25.90%), and birth asphyxia/hypoxic ischemic encephalopathy (HIE) 1301 (22.44%). The remaining 610 (10.52%) cases were infants of diabetic mothers, hemorrhagic disease of newborn, respiratory distress syndrome, congenital heart defects, congenital adrenal hyperplasia and few syndromic/metabolic diseases. Out of total admissions, 4431 (76.43%) were discharged after their complete treatment, 1087 (18.75%) died, 101 (1.74%) were shifted to pediatric surgery unit for surgical intervention, 33 (0.56%) left against medical advice (LAMA), and 145 (2.50%) were discharged on well (DOW) on their attendants request. Conclusion: Infection, jaundice and birth asphyxia were the main reasons of neonatal hospitalization in our study. Increased awareness about proper and structured antenatal care and safe hospital deliveries, discouraging home deliveries and utmost vigilance is needed for timely identification and referral of sick neonates to tertiary care hospitals by those healthcare professionals who perform deliveries at private medical centers and also for those health care professionals caring for the new born in peripheries. Special care is needed to improve the infection control settings of the newborn surroundings and strict hand washing of the attendants and health care professionals before handling the neonate.

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