CLINICAL FEATURES AND OUTCOME OF NEONATAL ENCEPHALOPATHY

Abstract

Background: Neonatal encephalopathy (NE) is a leading cause of neonatal morbidity and mortality especially in low and middle-income countries. It is defined as a defect of neurological function, which occurs in the first days of life, and is frequently linked to perinatal hypoxic-ischemic brain injury. Only few local studies exist about its clinical spectrum and short term outcomes in Pakistan. Objective: To determine the clinical features and outcome of neonatal encephalopathy presenting at Lady Reading Hospital / Medical Teaching Institute. Peshawar. Methods: This was a Cross-sectional study that was carried out at Department of pediatrics (Lady Reading Hospital) Peshawar. from December 2024 to May 2025. 120 neonates with NE born at more than 35 weeks gestation. A structured proforma was used to obtain the demographic details, clinical presentation, and immediate outcomes in the hospital, which were recorded in a prospective manner. Data analysis was done with SPSS version 25. Demographic variables were correlated with outcomes and a p-value of < 0.05 was regarded as statistically significant. Results: The most common clinical presentation was seizures in 58 (48.3%) neonates, respiratory distress in 39 (32.5%), lethargy in 14 (11.7%) and feeding difficulties in 9 (7.5%). In total, 103 (85.8%) neonates had an uneventful discharge while 17 (14.2%) died in the hospital. Low birth weight (<2.5 kg) and lower gestational age (p<0.05) were significant factors in mortality. Conclusion: The major clinical features of NE are seizures and respiratory difficulties. Although deaths were rare in most neonates, the overall mortality rate indicates the need for early diagnosis, timely treatment, and better neonatal care to minimize the negative effects of this condition.