Abstract
Background: Neonatal mortality rate is an important indicator which does not only reflect the overall health of a child and well-being but also assesses the social and economic development of a country.
 Aim: The study was carried out to determine the pattern and factors associated with neonatal mortality.
 Methods and Materials: It was a retrospective study carried out in the Special care Baby Unit of the Rivers State University Teaching Hospital from January 2016 to December 2020.
 Results: Of 2,944 neonatal admissions, 358 died giving a mortality of 12.2% with male preponderance (M:F ratio of 1.5:1). Majority of the neonates who died were admitted within the first 24 hours of life 289(80.7%) and were delivered via Caesarean section 195(54.4%). Most deaths occurred in the first 7 days of life 189(52.8%). The commonest cause of mortality was neonatal sepsis 183 (51.1%) followed by perinatal asphyxia 178(49.7%) and prematurity 176(49.2%). Most mortalities occurred between 4.00pm and 7.59 am 218(61.0%) outside regular work hours. The lowest annual mortality was recorded in the year 2020 (6.36%) while the highest was in the year 2018 (19.27%). There was significant mortality within 24hours of admission among neonates < 1.5 kg as well as those with sepsis, anaemia and neonatal jaundice.
 Conclusion: The mortality rate of neonates in the Rivers State University Teaching Hospital was high, 12.2% with neonatal sepsis, perinatal asphyxia and prematurity being the commonest causes which are largely preventable. There is therefore need to improve obstetric and newborn care to improve neonatal outcome.
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