Abstract
Introduction: The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Knowing the causes of morbidity and mortality is an essential step to improve neonatal health. The aim of this study is to describe the pattern and causes of neonatal admission, immediate hospital outcome in the form of improved, died or left against medical advice and factors associated with its outcome. 
 Methods: This was a retrospective hospital based study carried out in Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital, Kathmandu, Nepal over a period of six months (February 2019 to July 2019 AD). Neonatal details including age, sex, gestational age, birth weight, and maternal age and parity, mode of delivery, place of delivery, neonatal morbidities and neonatal outcomes were recorded in a predesigned performa. Results were expressed as mean, percentage and p value. P- value was calculated by using chi-square test.
 Results: A total of 163 neonates were admitted during the study period, among which 106 (65%) were males. The mean birth weight was 2483.96 ± 812.63 gm. Among admitted newborns 130 (79.8%) had good outcome, babies born to young mothers (< 20 years of age) had poor outcome which is statistically significant with p value of 0.002. Neonates whose birth weight were < 1000 gram had significantly poor outcome (0.001).
 Conclusion: Common causes of NICU admission were neonatal sepsis, neonatal hyperbilirubinemia, prematurity and perinatal asphyxia. Babies born to young primipara mothers, extremely low birth weight, extremely premature babies and babies undergoing mechanical ventilation had poor outcome.
Highlights
The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity
Neonatal sepsis was further divided into early onset neonatal sepsis (EONNS) when sepsis occurred within 72 hours of life and late onset neonatal sepsis (LONNS) when it occurred after 72 hours to 28 days of life
Knowing the existing pattern of neonatal morbidity and mortality in hospital setup like ours which represent the sickest population of neonates from all over the country plays the key role in determining appropriate measures to be applied by national health authority and stakeholders to improve the current situation and to meet the SDG goal of neonatal health of the country
Summary
The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Congenital anomalies (7%).2A previous study done in Nepal showed sepsis as the leading cause of hospital admission and mortality (34.5%). Followed by prematurity (23%) and perinatal asphyxia (23.3%).[4] As disease pattern vary from place to place and with time, even in the same place, regular neonatal auditing is vital but it is lacking in our country.[5] There are limited hospital based data regarding morbidity and mortality pattern of newborn in Nepal. Evidence based data on neonatal morbidities, mortalities and interventions especially facility based care are vital for formulating neonatal preventive health strategies to reduce neonatal mortality. We undertook this study to see the common causes of admission and the root cause of mortality which will help us prioritise the areas in neonatal health
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