Background: Congenital pneumonia is a serious neonatal condition, but its symptoms often overlap with other diseases, which may lead to overdiagnosis. This study aimed to assess the accuracy of congenital pneumonia diagnoses among neonates admitted to a tertiary NICU in Armenia.Method: We conducted a retrospective review of 106 NICU cases diagnosed with pneumonia in 2024. Every 7th neonate from an echocardiography database was included. Data on clinical presentation, imaging, laboratory results, and discharge diagnoses were analyzed. Cases were reclassified as congenital pneumonia, community-acquired pneumonia, or alternative conditions.Results: Of 106 neonates, 92 (86.7%) were diagnosed with congenital pneumonia and 7 (6.6%) with community-acquired pneumonia. Re-evaluation showed that 7 cases (6.6%) were due to other conditions: aspiration (2), neonatal seizures (2), ABO incompatibility (1), meconium aspiration (1), and anomalous pulmonary venous return (1). Most neonates were male (84 vs. 22 females), and nearly all were in the early neonatal period (96.2%). The majority came from regional provinces, particularly Lori (17), Ararat (16), and Armavir (13).Conclusion: A considerable proportion of neonates initially diagnosed with congenital pneumonia were later found to have other conditions. These findings suggest possible overuse of this diagnosis, especially in regional centers with limited diagnostic tools. More standardized diagnostic protocols and broader use of echocardiography may help improve accuracy, reduce unnecessary treatments, and strengthen neonatal care in Armenia.
