Abstract
Objective: To determine the frequency of different causes of neonatal admissions and mortality in relation to demographic characteristics at neonatal unit of Nishtar Hospital, Multan.
Methodology: It was a retrospective chart review, conducted at neonatal unit of Pediatric department, Nishtar Hospital, Multan from January 2016 to December 2016.
Results: Total neonates admitted in year 2016 were 3364. Sixty seven percent were males and 65.8% were low birth weight neonates. Main reasons of admission were birth asphyxia (34.27%), respiratory distress (27.44 %), neonatal infections (24.46 %) and prematurity (6.39 %). Fifty five percent newborns were admitted at <24 hours of age and 56.8% babies were born through spontaneous vaginal delivery. Significantly higher percentage (83%) of neonates were outborn (home or private clinic/hospital) compared to inborn. Highest number of admissions (51 %) was from Multan district. Fifty one percent of neonates were discharged with stable condition, 12.2% expired and 36.1% left against medical advice. The death rate was significantly higher in outborn as compared to inborn (~9.0 % vs. 3 %, p<0.001), and in babies with low birth weight in comparison to those with normal weight (~9.0 % vs. 3%, p<0.001). The predominant causes of deaths were respiratory distress syndrome (32.52 %), neonatal infections (29.37%) and birth asphyxia (19.17%).
Conclusion: The death rate was higher in preterm babies and in neonates with low birth weight. Steps to reduce neonatal deaths must be taken especially prompt referral of high risk pregnant mothers and newborns to tertiary care institutes, availability of trained attendant at the time of birth, proper management of preterm newborns and quick diagnosis with early appropriate antibiotic therapy.

Key words: Neonate, morbidity, mortality, asphyxia, sepsis