An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019

  • Rai Muhammad Asghar RMU
  • Muddasir Sharif RMU
  • Khalid Saheel
  • Rai Rijjal Ashraf RMU
  • Abid Hussain RMU
Keywords: Neonatal Mortality, Neonatal Intensive Care Unit.


Objective: This study was done to find out the main causes and magnitude of neonatal mortality in the neonatal intensive care unit (NICU) of Benazir Bhutto Hospital, Rawalpindi over a period of five years.
Material and Methods: A hospital-based cross-sectional study was done from June 2014 to July 2019. The registration book of admitted neonates was reviewed by using a checklist to collect data. Data was analyzed in SPSS 24 for descriptive and bi-variate analysis applying the chi-square test and presented in text, frequencies, tables, and percentages.
Results: The study assessed a total of 24,459 neonates admitted to the NICU at Benazir Bhutto Hospital over a span of five years (June 2014 to July 2019). The mean birth weight was 2432 grams ± 740 g (range: Between 800 and 6000 g). Male neonates accounted for 59.8% with male to female ratio of 1.5:1. 67.5% male neonates and 32.5% female neonates expired. Overall 19,832 neonates (81.1%) were discharged, while 4636 (18.9%) died, making a Neonatal Mortality Rate of 18.9% (189 per 1000 admissions). 86.21% of these deaths were early neonatal that occurred in the first week of life. The causes of death were pre-maturity/ low birth weight (LBW), suspected sepsis, birth asphyxia, neonatal jaundice, and meconium aspiration syndrome, accounting for 32%, 31%, 30%, 4%, and 3% respectively.
Conclusion: In our NICU the neonatal mortality is high with prematurity/low birth weight (LBW), birth asphyxia (BA), neonatal jaundice (NNJ), and meconium aspiration syndrome (MAS) accounting for most of the deaths. These deaths are largely preventable with better antenatal, perinatal, and neonatal care.


1. Pathirana J, Munoz FM, Abbing-Kara hagopian V et al.Neonatal death: case definition and guide lines for data collection, analysis and presentation of immunization safety data.vaccine 2016 dec;34(49):6027-6037.
2. Sustainable Development Goal 3. Ensure healthy lives and promote well-being for all at all ages Available at website accessed 03.09.2019
3. Hug L, Alexander M, You D, Alkema L. National, regional and global levels and trends in neonatal mortality between 1990 and 2017, with scenario, based projections to 2030:A systematic analysis. Lancet 2019 Jun 1;7(6):E 710-E720.
4. Ahmed M, Won Y.Gross-National Systematic Review of Neonatal Mortality and Post Natal Newborn Care: Special Focus on Pakistan. Int J Environ Res Public Health.2017 Dec;14(12):1442.
5. Dhaded SM, Somannavar MS, Vernekar SS, Goudar SS et al.Neonatal Mortality and Coverage of Essential Newborn Interventions 2010-2013:A prospective population based study from low-middle income countries.Reprod Health 2015;12(2):S2-S6.
6. Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O et al. Neonatalmortality: risk factors and causes: a prospective population based cohort study in urban Pakistan. Bull World Health Organ 87:130-8
7. Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin- Rector A, Dwyer L et al: Neonatal, postnatal, childhood and under -5 mortality for 187 countries, 1970-2010: a systemic analysis of progress towards Millennium Development Goal 4.Lancet 2010; 375(9730):1998-2008
8. Blanc AK, Wardlaw T. Monitoring Low Birth weight: An evaluation of international estimates and updated estimation procedure; Bull worldHealth Organ 2005; 83(3):161-240
9. Shane AL, Sanchez PJ, Stoll BJ.Neonatal Sepsis Lancet 20017 oct14;390(10104):1770-1780.
10. Graces AL, McClure EM, Perez W et al.The Global Network Neonatal Cause of Death, algorithm for low-resource settings. Actapaediatr.2017 Jun;106(6):904-911
11. UgwuGiMG. Pattern of morbidity and mortality in the newborn special care unit in a tertiary institution in the Niger Delta region of Nigeria: A two year prospective study. Global Advanced Research Journal of Medicine and Medical Sciences 2012; 1(6);133-8
12. Zulfiqar R, Naeemullah S: Neonatal mortality: Review from a tertiary hospital in Rawalpindi. Journal of Rawalpindi medical college (JRMC);2009;(1):2-6
13. Manzar N, Manzar B, Yaqoob A, Ahmed M, Kumar J.The study of etiological and demographic characteristics of neonatal mortality and morbidity- a consecutive case series study. BMC pediatrics 2012; 12:13
14. Shirazi H, Riaz S, Mahmood RA.Morbidity and Mortality pattern of Newly born babies in a teaching hospital.JRMC 2015;19(3);204-208
15. Kumar MK, Thakur SN, Singh BB. Study of morbidity and the mortality patterns in NICU at tertiary care teaching hospital in Rohtas district, Bihar, India. JCDR2012; 6(2): 282-5
16. Owusu BA, Lim A, makaje N et al.Neonatal mortality at the neonatal unit, the situation at a teaching hospital in Ghana.Afr Health Sci.2018 Jun;18(2):369-377.
17. Thomson J, Schaefer M, Caminoa B et al.Improved Neonatal Mortality at a District Hospital in Aweil, South Sudan.Journal of Tropical Paediatrics .2017 Jun;63(3):189-195.
18. Islam MN. Situation of neonatal health in Bangladesh Orion2006:Available at website http:/ medicaljournal vol.6.
19. Gebremariam A. Factors predisposing to low birth weight in JimmuHospital South Western Ethiopia. East Afr Med J 2005;82(11):554-8
20. Nahar J, Zabeen B, Akhter S, Azad K, Nahar N: Neonatal morbidity and mortality pattern in the special care baby unit of BIRDEM. Ibrahim MedColl J 2007;1((2):1-4
21. Shah GS, Singh R, Das BK. Outcome of newborn with birth asphyxia. JNepal Med Assoc 2005;44(158):44-6
22. Alves JB, Gabani FL, Ferrari RAP et al.Neonatal Sepsis Mortality in a Municipality in Southern Brazil,2000-2013.Rev Paul Pediatr.2018 Apr-Jun;36(2):132-140.
23. Thapa B, Thapa A, Aryal DR et al.Neonatal Sepsis as a Major Cause of Morbidity in a Tertiary Centre in Kathmandu.JNMA J Nepal Med Assoc.2013 Oct-Dec;52 (192):549-56.
24. Meshram RM, Gajimwar VS, Swapnil D et al.Predictors of Moratality in Outborns with Neonatal Sepsis;A Prospective Observational Study.Niger Postgrad Med J.Oct-Dec.2019;26(4):216-222.
How to Cite
Asghar R, Sharif M, Saheel K, Ashraf R, Hussain A. An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019. JRMC [Internet]. 30Dec.2020 [cited 2Oct.2022];24(4):328-33. Available from: