World Journal of Pediatrics

, Volume 13, Issue 1, pp 57–62 | Cite as

Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study

  • Muhammad Ayaz MustufaEmail author
  • Munir Ahmed Sheikh
  • Ijaz-ul-Haque Taseer
  • Syed Jamal Raza
  • Muhammad Sohail Arshad
  • Tasleem Akhter
  • Ghazala Mohyuddin Arain
  • Sultana Habibullah
  • Sohail Safdar
  • Rukhsana Firdous
  • Muhammad Adnan
Original article



Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies.


A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality.


We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn.


Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.

Key words

autopsy child health services early childhood emergency department use neonatal mortality 


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All the authors are thankful to PMRC for providing funds. The project was Conducted under PMRC grant no.4-17-1/09/RDC/Multicenter/Verbal Autopsy/NICH.


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Muhammad Ayaz Mustufa
    • 1
    • 9
    Email author
  • Munir Ahmed Sheikh
    • 2
  • Ijaz-ul-Haque Taseer
    • 3
  • Syed Jamal Raza
    • 1
  • Muhammad Sohail Arshad
    • 3
  • Tasleem Akhter
    • 4
  • Ghazala Mohyuddin Arain
    • 5
  • Sultana Habibullah
    • 6
  • Sohail Safdar
    • 3
  • Rukhsana Firdous
    • 7
  • Muhammad Adnan
    • 8
  1. 1.PMRC Specialized Research Center on Child HealthNational Institute of Child HealthKarachiPakistan
  2. 2.PMRC Research CenterLiaquat University of Health and Medical Sciences, JamshoroHyderabadPakistan
  3. 3.PMRC Research CenterNishtar Medical CollegeMultanPakistan
  4. 4.PMRC Research CenterKhyber Medical CollegePeshawarPakistan
  5. 5.PMRC Research CenterPunjab Medical CollegeFaisalabadPakistan
  6. 6.PMRC Research CenterDow University of Health SciencesKarachiPakistan
  7. 7.PMRC Research CenterBolan Medical CollegeQuettaPakistan
  8. 8.PMRC Research CenterFJMCLahorePakistan
  9. 9.5th Floor, PMRC Specialized Research Center on Child HealthNational Institute of Child HealthKarachiPakistan

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